Oral Answers to Questions

FOREIGN AND COMMONWEALTH OFFICE

The Secretary of State was asked—

Middle East

Lee Scott: What steps are being taken in pursuance of United Nations resolution 1701 to disarm Hezbollah and secure the release of Israeli soldiers held hostage.

Margaret Beckett: The deployment of the Lebanese armed forces and UNIFIL—the United Nations Interim Force in Lebanon—in southern Lebanon in accordance with UN Security Council resolution 1701 has had a positive effect on security in the area and has helped to reaffirm the authority of the Government of Lebanon. That Government should be the only body able to authorise use of force in Lebanon.
	My visit to Lebanon on 1 and 2 December was undertaken to show support for the constitutionally elected Government and for the full implementation of the UN resolution. We continue to call for the immediate release of captured Israeli soldiers and support efforts by the UN to broker their release.

Lee Scott: Will the Foreign Secretary lobby further the UN and the International Committee of the Red Cross on the release of the two Israeli hostages? There have been no reports on either of them and their families have had no word on whether they are alive. I ask for that lobbying to take place immediately.

Margaret Beckett: I can assure the hon. Gentleman that we keep in continual contact with all the many disparate individuals and groups endeavouring to obtain the release of the soldiers. Indeed, I met the wife of one of them in London a few days ago. I agree with the hon. Gentleman that it is particularly tragic that those holding the soldiers have so far not even been prepared to provide proof of life. That is very distressing for the families. Everyone is doing everything they can to procure the soldiers' release.

Louise Ellman: Is my right hon. Friend aware that the UNIFIL commander, General Pellegrini, has stated that he is unable to prevent arms from Iran and Syria from being passed to Hezbollah? How seriously does she take that violation of the UN resolution?

Margaret Beckett: As my hon. Friend probably knows, we take such issues very seriously and we continue to work with the Lebanese authorities—and to work through the European Union—to do everything that can be done to strengthen border security. There are obviously concerns about arms passing across the border. At present, there is a certain amount of dispute about whether, and to what degree, such transfer is taking place, but all such transfer is undesirable and we will try to halt it.

John Butterfill: Will the Foreign Secretary join me in welcoming the Israeli Government's decision not to take immediate retaliatory action if they suffer rocket attacks? Does she agree that that is a courageous decision that might help the middle east peace process, particularly if Hamas can play its part by restraining the Palestinians from launching such attacks?

Margaret Beckett: I completely agree with what the hon. Gentleman says, and I think that most people would. There have been many previous attempts to pursue the peace process, and many of them havebeen bedevilled by one side or another reacting very swiftly to provocations that were clearly designed to undermine it. The step that he mentions is very welcome, and I share his hope that such restraint is shown on both sides.

Richard Burden: Violations of resolution 1701 are obviously unacceptable from whichever side they come. Therefore, would my right hon. Friend also care to comment on the large number of Israeli overflights of Lebanon, which also violate resolution 1701? What representations is she making on that, bearing in mind that such overflights have been taking place since well before the events of this summer?

Margaret Beckett: I can tell my hon. Friend that we have indeed made repeated representations to the Israeli Government on the issue of overflight, particularly since the events of the summer. I am sure he knows that this discussion goes straight back to the point raised by my hon. Friend the Member for Liverpool, Riverside (Mrs. Ellman) on whether arms continue to flow into Lebanon. Nevertheless, we accept that that tactic can bring considerable dangers in itself, and we have urged the Israeli Government to cease using it.

Keith Simpson: The Foreign Secretary said that she was recently in Lebanon giving support to the Lebanese Government. Is she convinced that they will be able to face down the extra-parliamentary demonstrations that are taking place, or is she concerned that they will result in the fall of the Lebanese Government and effectively lead to a Hezbollah regime that will be to the benefit of neither the Lebanese people nor Lebanon's neighbours?

Margaret Beckett: There can be no certainty about the situation in Lebanon, and I share the concern that the hon. Gentleman has expressed. Certainly, the step that is being taken, with the clearly expressed wish of bringing down the elected Government, is potentially very damaging and destabilising. When I was in Lebanon, among the points I made to my many interlocutors were, first, that the international community supports the Government—whom the people of Lebanon themselves elected—and secondly, that there are many pressing issues and problems on the plate of that Government and of the Lebanese people in reconstructing their country, and that that should surely be their top priority.

Gerald Kaufman: As the Israeli soldiers remain captive four months after a war that devastated large parts of Lebanon and killed huge numbers of Lebanese civilians—and Israeli civilians, too—does that not make the visit of my right hon. Friend the Prime Minister to Washington this week all the more important in terms of emphasising that none of these problems can be solved without an overall settlement in the middle east?

Margaret Beckett: My right hon. Friend is entirely correct. We have repeatedly made the point—not only in Lebanon, but at the broader middle east conference in Jordan a couple of days beforehand—that although moves toward a peace process in Israel and Palestine are not sufficient to solve all the problems of the region, they are a necessary step, since none of the other problems of the region is likely to be resolved without them.

Iraq

Vincent Cable: What recent discussions she has had with the Government of Iraq and other Governments about war reparations.

Kim Howells: I have met the Governments of key debt holders and urged them to consider the long-term benefits of reducing the burden of Saddam Hussein's legacy, including the financial burden. As part of the Paris Club creditors' agreement, the United Kingdom has agreed to forgive 80 per cent. of the Iraqi debt to the UK. Other countries have also slashed Iraqi debt, but some—especially among Iraq's Arab neighbours—have declined to do so. We continue to encourage others to follow our lead in order to help significantly with the vital reconstruction of the Iraqi economy.

Vincent Cable: I welcome the tone of the Minister's reply, but why have the Government acquiesced in an arrangement whereby $40 billion of Iraqi oil money that should have gone into reconstruction and development has been siphoned off for reparations, including very large payments to companies such as Bechtel, Halliburton and even Kentucky Fried Chicken for lost profit opportunities during the first Gulf war? Is that not obscene, as well as stupid?

Kim Howells: I am not entirely sure that I go along with the adjectives that the hon. Gentleman has just used. I remind him and the House that reparations for losses incurred as a result of the Iraqi invasion of Kuwait have been dealt with by the United Nations Compensation Commission, which was set up by the United Nations Security Council in 1993. These have been paid out of the UNCC compensation fund, and payments to British recipients have now been completed.
	I do agree with the hon. Gentleman, however, in that the vital need is to reconstruct Iraq. This situation does not help and is unsatisfactory, and I certainly agree that the new democratic Iraqi Government should not have to pay for the crimes of Saddam. However, thosewho loaned money to Iraq and who suffered under the Iraqi occupation of Kuwait have a right to expect recompense—a right that was recognised, as I said, by the United Nations.

Jim Cousins: Does my hon. Friend not agree that the UNCC regime must be brought to an end? It undermines the democratically elected Government of Iraq, because they are forced to levy their oil revenues to pay wealthy Kuwaitis and American big business. It is a regime imposed by the United Nations that was appropriate in its time, but its time is now over. Will the Government help to bring it to an end?

Kim Howells: We have made it clear to the Paris Club creditors' that this debt burden is a significant hindrance to the reconstruction of Iraq. However, I should point out that many honest businesses and countries suffered as a consequence of Saddam Hussein's invasion of Kuwait—not least the Kuwaitis themselves. I am sure that in a perfect world we could bring this situation to early closure, and we have to convince those Governments and companies that that is the right thing to do. Believe me, some of those Governments and companies feel extremely bitter about the losses that occurred as a consequence of Saddam Hussein's illegal action.

David Heathcoat-Amory: Does the Minister agree that a resolution of the reparations question must involve the regional powers, such as Syria and Iran, and that an allied withdrawal from Iraq would force those countries to face up to their responsibilities in the region? Rather than arming the militias in Iraq and fomenting the civil war there, they should start to build for stability. So in fact, an allied withdrawal might accelerate peace and stability in the region.

Kim Howells: I certainly agree with the right hon. Gentleman that Syria and Iran—the two main countries that he is talking about—should take a much more positive role to try to bring stability and prosperity to Iraq. We have to talk not just to the Syrians and the Iranians, but, most importantly, tothe Iraqi Government—the democratically elected Government of Prime Minister al-Maliki. They have made it clear to us that they want a transfer of responsibility for security and for shaping the future of their own country. They very much hope that their neighbours will play a more positive role, and have been trying to achieve that in discussions with Syria and Iran.
	I note that Syria, for example, is to open an embassy in Baghdad, which is a good move. However, I am not sure that a hasty retreat from Iraq would necessarily help that process. We have to undertake it in stages carefully and, most importantly, with the co-operation of the Iraqi Government.

Russell Brown: What are the Government doing to improve quality of life for ordinary Iraqis, in southern Iraq in particular?

Kim Howells: My hon. Friend asks a pertinent question, as those issues hardly get any coverage in this country. I was in Basra last week and saw for myself how initiatives such as Operations Sinbad and Better Basra are achieving a great deal. I know that the right hon. Member for Richmond, Yorks (Mr. Hague), who speaks on foreign affairs for Her Majesty's Opposition, has also been in Iraq recently.
	I saw one project that alone involves the planting of 8,000 date palms, as part of Operation Sinbad, and employs 4,000 people in Basra. What Basra needs above all is for young men and women to get jobs and not to be prey to the militias that cynically use them to kill our troops. Many good things are happening in southern Iraq, and in the Basra area in particular, which is reflected in the urge of the provincial Government and other authorities in southern Iraq to take on more responsibility.

Ann Clwyd: While we are talking about war reparations, will my hon. Friend look at the situation of the British people taken hostage in Kuwait when a British Airways plane landed there during the invasion of that country by Saddam Hussein? Many of those families were taken to Iraq as human shields and many are still suffering from the trauma of their ordeal. The Americans on the plane received compensation; the British never have. Will my hon. Friend look again at the matter?

Kim Howells: I will be only too glad to do so. I know that my right hon. Friend feels strongly about what happened during the early days and weeks after the invasion of Kuwait. I believe that a comprehensive statement was issued by the previous Government, and I shall be glad to furnish her with a copy so that she and I between us might be able to discover what compensation might be paid out.

Cluster Munitions

John Leech: What assessment she has made of progress towards banning cluster munitions; and if she will make a statement.

Willie Rennie: What assessment she has made of progress towards banning cluster munitions; and if she will make a statement.

Geoff Hoon: The United Kingdom raised the question of cluster munitions at the recent review conference on the convention of certain conventional weapons, and we secured an agreement to hold urgent expert-level discussions on their humanitarian impact. My hon. Friend the Minister for the Middle East explained Government policy in a written ministerial statement issued yesterday.

John Leech: In the 108 days since the ceasefire,177 people have been injured or killed by unexploded bomblets from cluster munitions in southern Lebanon. If casualties continue at the current rate, by 2007, when the Government's proposed discussions are to take place, the figure will have risen to 500. Will the Minister make a commitment to hold truly urgent discussions with the Israeli Government regarding their violation of international law through their use of cluster bombs this summer?

Geoff Hoon: The hon. Gentleman sets out clearly the nature of the problem. That is why the United Kingdom led the initiative at the recent CCW review conference for urgent discussions to take forward a comprehensive solution to the problem he describes so well. In addition, as my right hon. Friend the Foreign Secretary demonstrated on her recent visit to the area, the UK Government have provided financial assistance for the clearance of unexploded ordnance in southern Lebanon and we will continue to provide such assistance.

Willie Rennie: The Government have been trying to draw a clear distinction between smart and dumb cluster bombs—the latter of which they apparently disapprove of. Why then are they waiting until the middle of the next decade before ridding themselves of the large stockpile of dumb cluster munitions? Why not ditch them now?

Geoff Hoon: I accept the implicit criticism in the hon. Gentleman's observation about the distinction between smart and dumb weapons. However, the matter is not as clear cut as that. There is no internationally agreed definition. He has to face up to the fact that that weapons system, if used properly and in accordance with humanitarian law—that is, where there is no direct threat to the lives of civilians—is the most effective weapon for dealing with armour. He has to bear it in mind that, for example, if that weapons system was not available to British forces under threat from an armoured group, large amounts of high explosives would be required to deal with that threat, so there would be greater risk to the civilian population and greater risk of further damage to people in the area.
	That is why it is appropriate to use this weapons system in accordance with humanitarian law, but at the same time to ensure that we take steps as best we can to reach an agreement internationally that, in particular, those weapons that cannot be properly targeted—those considered dumb, in the language that the hon. Gentleman uses—should not be used by any country.

Shahid Malik: Is my right hon. Friend aware that, according to the Mines Advisory Group and a cross-party group that was in Lebanon last month, some 32.7 million sq m of land are infected and contaminated by cluster munitions? According to the Mines Advisory Group, if the Israelis were to give it grid references for the 1.2 million bombs that were let loose in the last three days of action, instead of three children dying a day, as is the case, the number would, it hopes, be much less. Will he use his good offices to ensure that we put sufficient pressure on the Israeli Government to move forward on this important issue?

Geoff Hoon: My hon. Friend is quite right. We have repeatedly urged the Israeli Government to provide the UN with detailed maps and other help in locating unexploded cluster munitions in the area that he describes. There is, however, a very determined effort under way to clear that area of unexploded weapons. As I have already indicated, we have given significant financial help to that effort.

Andy Reed: Although I understand my right hon. Friend's assessment of the military capability of thoseweapons, does he understand that the humanitarian consequences are so vast that there is a requirement to move as quickly as possible? What assessment has he made of the progress and what chance does he think there is of reaching an international solution in the way that we did for land mines?

Geoff Hoon: That is why the United Kingdom has adopted the approach that I set out. What is important is that we secure an international agreement in precisely the way that we did in relation to land mines, as my hon. Friend indicated. It is important that all countries move together as part of international law on this question. However, I emphasise that the United Kingdom's use of that particular weapons system is always governed by humanitarian law.

James Clappison: But should not equal priority be given to removing the causesof conflict, which lead to the use of destructive armaments such as these and, for that matter, the 4,000 missiles that were rained down on Israeli towns and cities at the beginning of this conflict and which have a pretty contaminating and non-humanitarian impact on those who are on the receiving end of them?
	Will the Minister give equal priority to supporting all those in the middle east who seek a peaceful solution, including the President of the Palestinian Authority and the Prime Minister of Israel? Would not a good start be made if there was an initial settlement that led to the release of the two hostages, Ehud Goldwasser and Eldad Regev?

Geoff Hoon: Of course, my right hon. Friends the Prime Minister and the Foreign Secretary, as I mentioned, were in the region very recently, as was my hon. Friend the Minister for the Middle East. So, a determined effort has been made by the Government, and will go on being made, to reduce the causes of conflict and to find a way back to a peace process.

David Drew: I welcome what my right hon. Friend has to say and the written statement in particular. Does he agree that one thing that we could bring forth at the CCW conference in a year's time would be a clear statement that we intend to publish details of our stocks of cluster munitions in the hope that all other countries do so? If that could be done, we would at least know the nature of the problem with which we are dealing.

Geoff Hoon: I accept the point that my hon. Friend makes, but when trying to ensure that all countries respect international law, it is important that there is an international agreement. That is why we have taken the initiative, which I believe represents the best way forward. As other hon. and right hon. Members have said, the initiative is a route towards a comprehensive international ban.

Michael Moore: In the past couple of weeks, we have begun a useful debate on this subject in Parliament, and I pay tribute to Landmine Action and others for the work that they do in this area.
	May I press the Minister on his answer to my hon. Friend the Member for Dunfermline and West Fife (Willie Rennie)? The right hon. Gentleman did not tell us why, if it is a matter of principle to get rid of dumb cluster munitions, it will take until the middle of the next decade for the British to do that. More generally, does not the Government's distinction between dumb and smart cluster munitions ignore the reality that the smart bombs can have an unacceptably high failure rate of 10 per cent? Surely the bottom line is that we should be getting rid of all cluster munitions.

Geoff Hoon: I am not going to give the hon. Gentleman and the House a lecture on the distinctions between dumb and smart weapons. One problem is that the word "smart" is generally used to refer to a guided weapon. Unfortunately, in this context, "smart" is also used to refer to the ability of this particular weapon to self-destruct if it has not exploded after a period of time.
	A smart cluster bomb ought to be guided and should self-destruct after a period of time. However, I accept that the definitions are sometimes used imprecisely. I also accept that it is important that we move together with other countries to try to find a comprehensive way to resolve the problem. I do not wish to repeat all the points that I have made about the use of the weapons system, but I assure the House that the United Kingdom Government have only ever used such weapons fully in accordance with international law.

David Taylor: Has the Minister read research by Handicap International that demonstrates quite clearly that 98 per cent. of casualties from cluster munitions are civilians and that a third are children? Can he justify to the House how it is right that civilians should be allowed to go back to homes and fields that are clustered with explosive debris? Will he work with the International Committee of the Red Cross to try to overcome intransigence—especially on the part of the United States of America and Russia—over getting a ban on such munitions?

Geoff Hoon: I am not even going to try to justifywhat my hon. Friend describes. It is appalling that children—or anyone—are damaged by such weapons when they fail to explode, because that is an indication that they have been used in circumstances in whichthe United Kingdom would not use them. It is important to emphasise that great care is taken by our commanders in the field to ensure that the provisions of humanitarian law are recognised and respected. By implication, my hon. Friend made clear the importance of getting a comprehensive international agreement on these weapons, which I emphasise.

Elfyn Llwyd: In an effort not to be dumb, may I put one simple point to the Minister? As part of the Government's efforts to achieve an international ban on cluster bombs, would it not assist if the UK gave them up first, thus taking the moral high ground? I remind him that while unilateral disarmament might not be the flavour of the month among those on the Treasury Bench at present, it might be a good idea during the negotiations.

Geoff Hoon: As my hon. Friend the Minister for the Middle East did in yesterday's written ministerial statement, I have made it clear that the Government's intention is to phase out a certain kind of these systems—I say that without repeating the word used by the hon. Gentleman. I agree with him to the extent that it is important that we lead the way on that. However, equally, it is vital that we use the existing framework that is available to all countries that own and use those systems, and that there is a comprehensive agreement. Kofi Annan has made it clear that the parties should use the existing CCW framework, and that is the approach on which the United Kingdom Government have led the way.

Zimbabwe

Henry Bellingham: When she next expects to meet her European Union counterparts to discuss the effectiveness of current sanctions against Zimbabwe.

Geoff Hoon: My right hon. Friend the Foreign Secretary discussed Zimbabwe with her EU counterparts in October. I have also had discussions on that country, including with my Portuguese counterpart. There will be further discussion of the EU's targeted measures against Zimbabwe early next year, before their expiry in February. We believe that the measures, which target the regime members and not ordinary Zimbabweans, are effective and should be continued.

Henry Bellingham: The Minister will be aware ofthe total collapse of Zimbabwe's infrastructure and the rampant hyperinflation, with the cost of water in Harare last week increasing from 8 to 130 Zimbabwean dollars per unit. Is he also aware of the horrific human rights abuses, including the recent police attacks on the trade union vice-president Lucia Matibenga, which resulted in a broken arm? Surely the time has come for our Government and Europe to tighten smart sanctions and travel bans, which do not affect Zimbabwe's hard-pressed citizens, but are aimed at Mugabe and his evil henchmen?

Geoff Hoon: May I make it clear that the UK condemns the most recent assaults on ordinary Zimbabweans? The organisation Women of Zimbabwe Arise shuns any form of violent demonstration and has a history of peaceful protest; there can be no excuse for the attacks that its members have suffered. The beating of women and children only two months after the abuse of the trade union leadership is further evidence of Zimbabwe's terrible human rights record, which Robert Mugabe tries to argue is a figment of the west's imagination.
	I agree with the hon. Gentleman that it is vital that we continue to isolate the regime, but, as his opening observations made clear, we have no quarrel with the people of Zimbabwe and no reason to cause further harm to a population who are already suffering as a result of the appalling decisions of their leaders. That is why we draw the distinction between sanctions that are aimed at the regime and other measures that might further damage the people of Zimbabwe.

Brian Jenkins: Although I welcome the talks on Zimbabwe with our EU partners, should not more effort be spent in talking to Zimbabwe's neighbours, whose actions might have more effect, and to countries such as China, which continue to invest in Zimbabwe?

Geoff Hoon: I agree that all parts of the international community, and in particular Zimbabwe's near neighbours, could do more. It is important to continue to isolate the regime, and it is vital to world opinion that the countries of southern Africa take united and effective action to isolate Zimbabwe. I strongly agree with my hon. Friend's comments.

Julian Lewis: Is it not a fact that there are no practical consequences that the Minister can name that have affected the leaders of Zimbabwe as a result of the sanctions? To follow up the suggestion made by the hon. Member for Tamworth (Mr. Jenkins), is it not necessary to do more and not only talk to Zimbabwe's neighbours, but pin them down to practical measures that they can impose and we cannot?

Geoff Hoon: I have made it clear that we would likethe international community, including Zimbabwe's southern African neighbours, to do more, but I do not accept that there are no practical consequences. If that were so, the regime in Zimbabwe would not protest so loud and so long about the impact that the sanctions have. The fact is that its leaders do protest, which means that the sanctions are having some effect on them.

Burma

Alistair Carmichael: If she will make a statement on the human rights situation in Burma.

Ian McCartney: The human rights situation in Burma remains dire. Serious human rights abuses are being committed, particularly in areas of armed conflict. The Burmese people do not enjoy the most basic human rights—including the right of freedom of speech and association—democracy and good governance, and the rule of law.
	The Burmese Government have recently orderedthe International Committee of the Red Cross to close its field offices. The Under-Secretary of State for International Development and I have issued strong statements condemning that action, which I have placed in the Library of the House.
	I discussed the human rights situation in Burmawith UN Under-Secretary-General Gambari on15 November. I have also invited Juan Mendez, UN special adviser for the prevention of genocide, tobrief Members of both Houses of Parliament on14 December.

Alistair Carmichael: I thank the Minister for that full answer. It has been the policy of this country for many years to discourage UK companies from investing in and trading with Burma, but despite that the human rights situation in that country has worsened, as hehas just described. What consideration have the Government given to shifting from a policy of discouragement to one of prohibition? Does he accept that if we did that, we would have a great deal more moral authority when we were trying to discourage other countries in the region from trading with and investing in Burma?

Ian McCartney: I thank the hon. Gentleman for his question and for the way he worded it. It reflects the common approach across the House and shows how effective that can be. There is a common European Union position on the matter, which includes an arms embargo, a ban on defence links, a ban on high level Government visits to Burma and a ban on the supply of equipment. As a result of our discouragement, British companies have been disinvesting in Burma to the point that there is little or no UK investment in Burma or its overseas territories. I assure the hon. Gentleman that the best chance we have of imposing embargos is through the EU. If we do so unilaterally, we will open the door to some countries in Europe which may not want to join in the strength of the common position. It is critical that the 25 countries maintain the same line and ensure that commitments given are carried through.

Mike Gapes: My right hon. Friend will be aware that the Chinese Government have extensive economic and political relations with Burma. What representations has he made to the Chinese authorities about these matters? Is he optimistic that China will eventually move into line with the body of international opinion?

Ian McCartney: I have not only raised the matter with my counterpart in China and with the ambassador on numerous occasions, but in recent days I have taken the opportunity to speak to my counterpart in India, and yesterday I met the representatives of countries in the Association of South East Asian Nations to talk through with them a more proactive approach by the ASEAN countries. Last evening I met the Foreign Minister of Brunei, who is chair of the ASEAN group, to discuss with him a more practical approach by ASEAN, along with India and China, to try and resolve the issues on behalf of the people of Burma.

Geoffrey Clifton-Brown: Following the pretty bleak reply that the Minister gave on the Burmese regime, does he agree that it is one of the most evil regimes in the world in terms of its human rights record? Recent reports say that Burma has the highest recruitment of child soldiers, and routine rape and torture of women and young girls. That is unacceptable. What further action is the Minister taking within the European Union so that certain countries do not block a UN resolution? Does he agree that tougher action needs to be taken by China and Russia so that together the international community can bring forth a real and workable UN resolution to stop the regime committing such human rights abuses?

Ian McCartney: I thank the hon. Gentleman. First, I have spoken directly with the Burmese ambassador on numerous occasions, with a range of allegations backed up by firm evidence. To date the response has been negative. No responsibility is accepted, including for rape by army officers and army personnel. Secondly, I have had personal and detailed discussions with all the countries that the hon. Gentleman mentions, except Russia. As I said to Mr. Gambari when we met recently, our commitment is to support a UN resolution. All our efforts among our European colleagues and colleagues in the ASEAN group are important to get maximum support for any further Security Council resolution. That is why I have invited a UN representative to come here on 14 December and give a report to Members of both Houses. It is important that hon. Members of both Houses have the opportunity to meet a UN representative and to discuss with him in person the role of the UN working with us as a Government. Not everyone can fly to Geneva or New York, so we are bringing Geneva and New York here. The hon. Gentleman and the hon. Member for Orkney and Shetland (Mr. Carmichael) are welcome to attend the meeting, which is a genuine effort by me to open up the dialogue and give others the chance to put the case for the Burmese people.

Iraq

Boris Johnson: If she will make a statement on recent political progress in Iraq.

Malcolm Rifkind: What recent political progress has been made in Iraq; and if she will make a statement.

Margaret Beckett: Iraqi leaders have reaffirmed their commitment to national unity. The national reconciliation initiative is being pursued and the constitutional review committee has now been formed. On security, two provinces have already been handed over to Iraqi control and four more will follow this month. Agreement has also been reached to transfer four of the 10 Iraqi army divisions from the multinational force to Iraqi command and control this year. Political progress is, though, still being hampered by high levels of sectarian violence specifically aimed at undermining the Government's efforts to improve security. We will continue to support the Iraqi Government in their work.

Boris Johnson: What can the Foreign Secretary say to disprove the withering verdict of the US State Department official, Kendall Myers, that Washington has systematically ignored British advice over Iraq? Can she give a single concrete example of any piece of advice given by her or the Prime Minister that was accepted by Washington and without which the catastrophe in Iraq would have been even worse?

Margaret Beckett: I could certainly give the hon. Gentleman many examples of advice that we have given that has been accepted by Washington. As regards Kendall Myers, I had never heard of him before and I do not suppose that I shall ever hear of him again— [ Interruption. ] The example with America goes back as far as Winston Churchill, a point of view that the hon. Gentleman might not wholly share.

Malcolm Rifkind: Does the Foreign Secretary agree with the view of the Secretary-General of the United Nations that Iraq is now in a state of civil war? A simple yes or no answer would be very helpful.

Margaret Beckett: No. Furthermore, I would say to the right hon. and learned Gentleman, who is very experienced in politics as well as in some of these issues, that it might have occurred to him, because it has certainly occurred to me, that it was not the Secretary-General who said that—not for the first time, the words were put into his mouth by a journalist.

David Winnick: Should there not be total condemnation from everyone in this House, whichever line they took at the time of the war, of the mass murder that is being carried out on a daily basis against completely innocent people by terrorists who have, needless to say, not the slightest interest in democracy? Since it is clear that the occupation troops can in no way stop what is happening, does my right hon. Friend accept that the continued reduction of British troops is to be welcomed? I hope that that will continue throughout next year.

Margaret Beckett: My hon. Friend is entirely right that everybody must, and does, condemn the terrible levels of violence and the nature of the violence—wanton violence—in Iraq, which seems to be aimed at nothing more than destroying the hope and the prospect of peace. It is confined to fewer areas than one is sometimes given the impression is the case from coverage in this country, but it is nevertheless quite appalling.
	My hon. Friend is also right to say that it is important that we continue with the process of handing over security responsibility to the Iraqi police and armed forces as they become able to take it on. Like him, I strongly hope that that process will continue.

Lynne Jones: As it would appear that the presence of forces responsible for the invasion is merely fuelling the insurgency,what discussions have taken place with the Iraqi Government about the desirability of handing over some of the responsibility to United Nations forces?

Margaret Beckett: Lots of discussions have taken place with the Iraqi Government about a transfer of responsibility, but I have detected no interest in the Iraqi Government in finding a new international force. Perhaps I could remind my hon. Friend, as she seems to have forgotten, that the multinational forces that are there are under the authority of the United Nations. The Iraqi Government are not interested in getting in a fresh set of international troops, but there is certainly interest in taking over control of security themselves—that is a view that we strongly share.
	Let me add that it is not the case that the presence of multinational forces is fuelling conflict in every part of Iraq—there are some areas where it may not be assisting and may even be adding to difficulties, but that is not so across Iraq. That is why the Iraqi Government are not asking for those forces simply to decamp.

William Hague: Given the pace of the policy reassessment going on in Washington, does the Foreign Secretary agree that it would be highly desirable for the Government to come to the House before the Christmas recess with a statement of policy on Iraq and on the prospects for our operations there? Will she describe the shape currently taken by any policy review going on in the Foreign Office, the Ministry of Defence or Downing street in parallel with the two reviews taking place in Washington? With or without that, what can she tell the House about the advice that the Prime Minister will give to President Bush when he travels to Washington tomorrow?

Margaret Beckett: The advice that the Prime Minister will give to President Bush is exactly the advice that he has shared with the House and, indeed, the country, on many occasions. It is on the need to give attention to supporting the Iraqi Government's efforts to improve services and infrastructure, and to improve and take greater responsibility for security, as they can. Obviously, it is not entirely up to me how matters are reported to the House, but I certainly give the right hon. Gentleman an undertaking that if there is a change that seems to require fresh information to be given to the House, I will be happy to give it, in one way or another.

William Hague: I am grateful for that answer, and of course I will pursue the matter. In the meantime, it is evident that military force alone will not resolve the current situation, and I know that the Foreign Secretary will agree that a broader political reconciliation in Iraq is indispensable to its future, but what does she think are the chances of arriving at such a situation in the next few months? Does she think that it is a good idea to establish an international contact group of countries that wish to help in such matters, and that have the influence to do so? Such a group could begin to provide the international framework to buttress any such agreement in the future.

Margaret Beckett: First, may I say that I strongly share the right hon. Gentleman's view—a view thatwe have been expressing continually to the Iraqi Government—that political reconciliation is imperative in Iraq? We have encouraged and supported that Government in that work. I can tell him and the House that, two or three days ago, I had a long and very fruitful conversation with the Iraqi Foreign Minister, who told me how much better those efforts are proceeding, and how encouraged he is that people there are seeing some improvement in the situation. I very much hope that the next few months will bring the kind of improvements that he, and we, seek. On the issue of an international contact group, I can tell the right hon. Gentleman that for some time we have urged Iraq's neighbours and its colleagues elsewhere—for example, in the Gulf and among the Arab states—both to join the international compact to support Iraq, and to be prepared to be engaged in a wider group helping to support and assist the Government of Iraq in their endeavours. We continue to make such representations, and I think that they are increasingly being taken seriously. Whether there will be a formal contact group is another matter, but support for the international compact will, I think, have the kind of effect that the right hon. Gentleman seeks.

Tony Lloyd: The Foreign Secretary must be right to emphasise the importance of Iraq's neighbours, who must be part of the solution, as regards the politics of Iraq. When my right hon. Friend the Prime Minister is in Washington, will he tell the United States Administration unequivocally that we must now talk, however reluctantly, to the Syrians and the Iranians? They must be part of any solution; if not, they will be part of the problem.

Margaret Beckett: Those countries are part of the problem now. I am sure that my right hon. Friend the Prime Minister will discuss with the President a whole range of matters, which will encompass the points rightly raised by my hon. Friend. It has long been clear—and, of late, we have made it explicitly clear—to, for example, the Syrians that people are prepared to talk to them, and that it is in their interests, and in the interests of Iran, and all of Iraq's other neighbours, that there should be a stable Iraq in the future. They might think about that a little more fully than they seem to do at the moment. Of course, although people are prepared to engage in dialogue—I am pleased, for example, that the Syrians are opening an embassy in Baghdad—the degree and the nature of that dialogue will depend on whether or not action is taken by both Syria and Iran that shows good will, as opposed to ill will.

Middle East

Jo Swinson: What discussions have taken place with the Israeli Government on the use of rubber bullets by the Israeli military against Palestinian protestors.

Kim Howells: We last raised our concerns about the use of rubber bullets on 30 August.

Jo Swinson: A report in 2002 by a group of Israeli researchers, including the then chief physician of the Israeli police force, recommended that rubber bullets
	"should...not be considered a safe method of crowd control."
	Despite that, on 4 August this year, my constituent, Margaret Pacetta, was shot in the back with a rubber bullet during a peaceful protest in the disputed village of Bilin, leaving her bruised and badly shaken. Will the Minister raise that issue again with the Israeli Government and ask them to follow the advice of the 2002 report?

Kim Howells: The hon. Lady is rightly concerned about what happened to her constituent, but she will acknowledge that rubber bullets are a hell of a lot better than ordinary metal ammunition, which tends to kill people or blow their arms off. There is not a general prohibition on the use of rubber bullets under international law—she will recall that the United Kingdom used them regularly in Northern Ireland. We expect the Israelis to use them only when necessary with proper control because, as she said, they are sometimes lethal. Our embassy in Tel Aviv raised that particular case with the Israeli authorities on 13 June, and our ambassador wrote on 15 June. The embassy pursued the case with the Israeli Ministry of Foreign Affairs on 30 August, and it asked the Israeli Government to clarify whether plastic or rubber bullets were fired at demonstrators and whether the crowd was beaten with batons. If so, it asked them to explain why such force was necessary, but it is still awaiting a response.

Brian Iddon: Mr. Liberman, who is a Member of the Knesset, believes that all Palestinians should be cleared out, not only from the occupied territories but from Israel. What chance is there of establishing a Palestinian state when a Knesset Member with racist views is holding the coalition Government together in Israel?

Kim Howells: I agree with my hon. Friend that it is an absurd situation, as that man holds views that are akin to those that prevailed under apartheid. He wants Palestinians to be driven out of Israel, but I am sure that that view is not held by most Israelis—it certainly is not held by most Palestinians. We should work wherever possible in our negotiations with the Israeli Government and generally in diplomacy to counteract such arguments.

Richard Younger-Ross: Will the Minister raise the issue of glass fibre shells, which have allegedly been used in Gaza, with the Israeli Government because, as doctors in the House will know, they leave small fragments that cannot be detected by X-ray?

Kim Howells: I will certainly make inquiries, but it is the first that I have heard about such munitions being used. If that is the case, we would certainly deplore their use.

Ceasefire (Gaza)

Jim Cunningham: If she will make a statement on the ceasefire in Gaza.

Kim Howells: We welcome the mutual ceasefire in Gaza between the Palestinians and Israel. Like everyone else, we were concerned that in the early part of the ceasefire Qassam rockets were fired from Gaza into Israel, but we welcome the public commitments of Prime Minister Olmert and President Abbas to make it work. All sides need to use this opportunity to take measures to restore confidence and return to the road map. A great deal of energy, commitment and continued effort is required from the international community to help to facilitate that.

Jim Cunningham: I thank my hon. Friend for his answer, but does he not think that it is time that pressure was put on the American Government to make a concerted effort to sort out the middle east question, particularly the road map to peace?

Kim Howells: My right hon. Friend the Prime Minister visited the region from 9 to 11 September and met key leaders. He believed that it was important to visit the region to exchange ideas and to start to identify a way forward for the parties, as that can lead to genuine dialogue through negotiations and a way back to the road map. I do not doubt that he will urge our American allies to devote more energy to that re-engagement in his impending visit to Washington.
	My right hon. Friend the Member for Torfaen (Mr. Murphy) recently visited Sri Lanka, and he put his finger on an important issue in peace building and efforts to reinvigorate the procedure. He noted that it is not enough for the parties to be brought together once every six months in Geneva—it is something that must be worked at day and night, as was the case under Prime Minister Major. People must construct back channels, and explore ways to bring the sides together. It is about peace building, and those are not easy techniques to evolve. We should not assume that it is enough to hold the occasional grand meeting at which the great and the good are brought together and various resolutions are arrived at. We have to do much more, as it is about building peace from the bottom up.

Douglas Hogg: May I reinforce what the Minister has just said about peace building? It is essential that both sides get rapid benefit. In the absence of rapid benefit, there is never support for the process.

Kim Howells: I agree entirely with the right hon. and learned Gentleman. As he knows as well as any of us, it should not be rocket science. I have met people who said that Egyptian contractors could be used to build 200,000 new houses in Gaza. Imagine what that would do for employment in the area. There are plenty of people with good intentions. There is no shortage of resources, but there is a shortage of political leadership and will to get on with it—and to get on with it quickly.

Cluster Munitions

Chris McCafferty: Whether the UK will be represented at the conference on cluster munitions in Oslo in February 2007; and if she will make a statement.

Geoff Hoon: Invitations to the conference on cluster munitions in Oslo in February have not yet been issued. We will carefully consider any such invitation, if and when it is received.

Chris McCafferty: Given that Kofi Annan has, among other things, called for a freeze pending the ban, and given that the expert-led urgent discussions will not report back to the review for a whole year, I urge the Government not only to attend the Oslo conference, but to take a lead part in discussions on a possible moratorium and, ultimately, a ban on these utterly abhorrent weapons.

Geoff Hoon: I am grateful for my hon. Friend's suggestion, but I answered her question as I did because we have not yet received any invitation, so we are not in a position to say whether we can attend or not. I agree with my hon. Friend that it is important to take forward a process, which is why we have taken the initiative and appointed a group of experts to look into the problem through the conference of the convention on certain conventional weapons in order to bring about the possibility of an international ban. I hope that my hon. Friend strongly supports that, which is precisely the process that Kofi Annan advocated.

Carbon Emissions

Andrew Selous: What recent discussions she has had with the Secretary of State for Environment, Food and Rural Affairs on international mechanisms to enforce the reduction of carbon emissions.

Margaret Beckett: I am in regular contact with the Secretary of State for Environment Food and Rural Affairs on how best to deliver the UK's climate objectives. I have made the joint pursuit of climate and energy security a strategic international priority for the UK. It is vital to our security and therefore a major focus of our diplomacy to achieve a rapid transition to a low-carbon global economy.

Andrew Selous: The Secretary of State for Environment Food and Rural Affairs is committed to UK and EU cuts in carbon emissions, but only the United Nations has the authority to take a global view of this issue, so will the Foreign Secretary press the UN to make climate change a central purpose—naming and shaming recalcitrant countries, if necessary—rather than the peripheral concern that it is now?

Margaret Beckett: I think that the hon. Gentleman is being unfair to the UN in saying that it is a peripheral concern. Indeed, at the recent United Nations framework convention on climate change conference in Nairobi, the Secretary-General made a very strong statement about the importance of this issue. I certainly share the hon. Gentleman's view that the matter should have even more prominence in UN discussions, which is something that we are urging on the new Secretary-General.

Graham Brady: The Secretary of State knows that we share her strong commitment to international co-operation to achieve carbon emission reductions. Does she share our view—and the view expressed by the Minister for Europe on 26 October—that it can be achieved without any additional EU powers?

Margaret Beckett: We are rather a long way from the international agreement that we all seek in the longer term. In the shorter term, we certainly believe that one of the main instruments that can be used to make progress is the EU emissions trading scheme and extensions to it. As the hon. Gentleman knows, this country is, I believe, the only one to have had its national allocation plan proposals for the new scheme accepted. That does not, at present, require any new powers.

North Korea

Greg Hands: What recent discussions she has had with her Chinese counterparts on North Korea's nuclear programme.

Ian McCartney: Immediately following North Korea's nuclear test in October, the Foreign Secretary had telephone conversations with her counterparts, including Chinese Foreign Minister Li. I also called the Democratic People's Republic of Korea ambassador in London to the Foreign Office to make our views clear. On a previous visit to the region in July, I discussed the issues with interlocutors from China, as well as Japan and South Korea, and my right hon. Friend the Deputy Prime Minister had further talks during his visit in October. We remain in direct and regular contact with the Chinese Government on the issue, including through our ambassador in Beijing and via other high-level ministerial and official contacts. China has an instrumental role to play in the resumption of the six-party talks and in ensuring that North Korea complies with UN Security Council resolution 1718.

Greg Hands: I thank the Minister for that answer. A few weeks ago, the Deputy Prime Minister told the House that he had had three hours of talks with the Chinese special envoy to North Korea at the end of October. Will the Minister tell us a little more about the content of those talks?

Ian McCartney: I do not want to be awkward and say, "No, because I wasn't in the room when the discussions took place." I can tell the hon. Gentleman, however, that if the Deputy Prime Minister spoke to the special envoy in the same way that I did, it will have been a very productive discussion.

Jeremy Hunt: Does the Minister accept that the situation in North Korea is a perfect illustration of why it is vital that we renew our nuclear deterrent? Does he agree that the argument that we are unlikely to use such a deterrent is not only wrong but dangerous when we are faced with an opponent such as North Korea, which accepts only one principle, namely, that might is right?

Ian McCartney: I take on board entirely what the hon. Gentleman says, and I thank him for his support of the Government's position. It is also really important that we get the six-party talks going again. It is critical that we resume those discussions. We already have talks about the talks under negotiation, and several points remain under discussion to be agreed between the United States and China. I hope that the talks will resume soon.

Opposition Day
	 — 
	[1(st) Allotted Day]

Public Health

Mr. Speaker: I inform the House that I have selected the amendments in the name of the Prime Minister in both of today's debates.

Andrew Lansley: I beg to move,
	That this House notes the Government's failure to improve public health outcomes and to reduce health inequalities; believes that the gap between the public health of the UK and that of comparable health economies is unacceptable; identifies obesity, smoking, sexually transmitted disease, infectious disease control, teenage pregnancy, alcohol and substance abuse, the promotion of healthy lifestyles and screening for treatable disease as areas of particular concern; supports frontline staff striving in adverse circumstances to improve the health of the nation; is concerned about the shortage of public health staff due to the Government's financial mismanagement; joins with the Chief Medical Officer in condemning the use of public health funds to tackle NHS deficits; and calls on the Government to ensure that funds for public health are spent on addressing remediable health issues.
	The Secretary of State has called me to explain that she would be unable to be here, and I quite understand why that is so. We hope that we shall see her later in the debate. I understand that the Under-Secretary of State for Health, the hon. Member for Bury, South (Mr. Lewis), will reply to the debate, and that the Minister of State, Department of Health, the hon. Member for Don Valley (Caroline Flint), will lead for the Government—

Shona McIsaac: They are a quality team.

Andrew Lansley: Yes, I admire them personally; it is politically that I have a problem.
	It is five years since we last had a debate on public health on the Floor of the House. That debate was also on an Opposition motion. Today, we want particularly to look at the Government's record on public health, two years after their White Paper and four and a half years after the Wanless report was produced for the Treasury. Tomorrow, the Chancellor of the Exchequer will come to the Dispatch Box and present his pre-Budget report. The Treasury has also received a tranche of other reports, including the Eddington report, the Leitch report and the Barker report, which was published today. I guess that the Cooksey report will be published tomorrow. The Chancellor is very good at commissioning reports. The day before his pre-Budget report, let us see how good he is at ensuring their implementation.
	Two years after Derek Wanless published his report to the Treasury, he looked at what had been achieved. Let us remind ourselves how important this matter is. His report set out to the Treasury and the public that, looking forward 20 years from 2002, if the NHS were able to achieve what he described as a fully engaged scenario in which productivity improved and technology was fully utilised in the NHS, and in which the public were fully engaged with their own health,the NHS would be spending £154 billion a year. If, however, the worst case scenario—that of a slow uptake—applied, in which those things did not happen, the figure would be £184 billion. There would be a£30 billion difference. He also expressed the difference in terms of life expectancy, predicting a difference of 2.9 years for men and 2.5 years for women by 2022.
	The NHS has not achieved the productivity gains that Derek Wanless set out. We also know from the repeated delays and confusion surrounding the connecting for health NHS information technology programme that technology is not being taken up in the NHS in the way that he anticipated. I want to focus, however, on the simple fact that we are not achieving that public health objective.
	In 2004, the final Wanless report said:
	"the challenge now is delivery and implementation, not further discussion. An NHS capable of facilitating a 'fully engaged' population will need to shift its focus from a national sickness service, which treats disease, to a national health service which focuses on preventing it."
	In 1997, the Government said that there would be a new public health drive. Yet again, we have seen good intentions but a failure to deliver.

Russell Brown: rose—

Andrew Lansley: Does the hon. Gentleman want to try to explain that?

Russell Brown: The hon. Gentleman mentions Mr. Derek Wanless. May I mention to him another gentleman, Professor Alex Markham, the chief executive of Cancer Research UK, to whom I spoke a couple of weeks ago? He said about the smoking ban:
	"This is the most importance advance in public health since Sir Richard Doll identified that smoking causes lung cancer fifty years ago."
	Does he agree with Professor Alex Markham?

Andrew Lansley: The smoking ban is important, and it was a decision reached by Parliament, not by the Government. On the day of the vote on the smoking ban, the Secretary of State for Health said in the morning that she would vote for an exemption for clubs, but by the afternoon she was voting against that. The Government will not get any plaudits for that ban.

Adrian Bailey: Will the hon. Gentleman give way?

Andrew Lansley: If the hon. Gentleman does not mind, I shall answer the hon. Member for Dumfries and Galloway (Mr. Brown) first.
	We must bear in mind the reduction in mortality rates from cancer, which have been sustained over a period of time, but at broadly the same trend rate. In which period of time was the reduction in the prevalence of cigarette smoking among adults the greatest? The answer is: from 1980 to 1990, when it reduced from 39 to 29 per cent. In the eight years since this Government came into office, it has reduced from 28 to 25 per cent. The previous Government set a target to bring the prevalence of smoking down to 20 per cent. by 2000. That was not reached, and it has not been reached since. If the hon. Member for Dumfries and Galloway is saying that smoking has been historically the most preventable cause of death, he is right. Action on it is necessary.

Adrian Bailey: Does the hon. Gentleman think that allowing tobacco advertising will reduce the prevalence of smoking, given that he and his colleagues voted against the Bill to ban it in 2002?

Tim Loughton: We did not vote against it on Third Reading.

Andrew Lansley: My hon. Friend reminds me from a sedentary position that we did not vote against it on Third Reading— [Interruption.] If the Minister wants to tell us about smoking, let us deal with that.
	Smoking rates are not falling as quickly as they did in the 1980s. Among young women in particular, smoking has not decreased as it ought to have done. This year, did the Government have a national campaign to coincide with national no smoking day? No, they did not. The two preceding years saw a 50 per cent. and a 40 per cent. increase in quit rates in the first quarter as a result of such campaigns. This year, in the absence of such a campaign, quit rates decreased by10 per cent. in the first quarter and calls to the helpline decreased by 30 per cent. Does the Minister wish to tell us why the Department of Health did not have a national campaign to promote giving up smoking this year? That campaign has not happened.

John Bercow: In light of the pervasive cynicism about politics and politicians, and given that it is important that we should practise what we preach, does my hon. Friend agree that the Smoking Room of the House should be renamed and the practice there prohibited?

Andrew Lansley: I am always so grateful to my hon. Friend for his questions. Happily, I am not responsible for any House of Commons matters and will not venture into that territory.
	Obesity is now the single most preventable cause of premature mortality. Since 1997, obesity in men has risen from 17 to 23.6 per cent. and obesity in women has risen from 19.7 to 23.8 per cent. In 1998, the Government abandoned the target that existed before 1997, but the Labour party's 1999 public health White Paper mentioned obesity only once in the context of it being a risk factor for coronary heart disease. It had no strategy for dealing with obesity.
	In July this year, the Office for National Statistics published the time use survey, which looks at how people spend their time. Its results astonished me.

Steve Webb: Will the hon. Gentleman give way?

Andrew Lansley: Let me explain the point first.
	In that survey, 15 per cent. of adults in 2000 said that they spent some proportion of their time during the day in sport and outdoor activities. By 2005—just five years later—that had fallen to 10 per cent. While there has been a complete absence of any strategyto promote physical activity on the part of the Government, what are we getting instead? A dramatic reduction in the number of adults engaged in physical activity, especially sport. Lottery funding for sporthas reduced from nearly £400 million in 1998 to£264 million.

Andy Reed: Will the hon. Gentleman give way?

Andrew Lansley: I shall give way to the hon. Member for Northavon (Steve Webb) first.
	The reduction of lottery spending on sport by a third has occurred at precisely the same time as a dramatic reduction in the number of people engaged in sporting activity.

Steve Webb: On the subject of how people use their time, I take the hon. Gentleman back to how he used his time in May 2005, when he was a passionate advocate for the patient's passport. Will he explain what impact that would have had on public health?

Andrew Lansley: No, because we are debating public health now.
	The Minister told us this morning about pilot projects that deal with physical activity. I am happy that we have had the local exercise action pilots. I am also happy that they have demonstrated some success. However, I am surprised that the Government thought that exercise referral schemes only happened in the context of their pilots.

Andy Reed: Will the hon. Gentleman give way?

Andrew Lansley: In a moment.
	Representing the constituency that I do, I am sure the Minister will be aware of the south Cambridgeshire physical activity strategy and the exercise referral schemes in the area, which is part of an evaluation conducted with the Medical Research Council's epidemiology unit. The proposal for that evaluation said:
	"A recent review of evidence on exercise referral schemes that included the findings of a Cochrane review reached the following conclusions".
	I shall quote just the first one:
	"Exercise referral schemes showed positive moderate sized effect on increasing self-reported physical activity in the short term but evidence of sustained effect beyond 12 months was lacking."
	That is why the evaluation is taking place.
	I looked at the so-called evaluation that the Government published with their pilot this morning. It says:
	"Overall the data supports the view that exercise referral is an effective intervention for initially engaging and facilitating physical activity change in adults and older adults".
	This is typical of the Government's gimmicks. We know that physical activity among older adults in particular gives benefits. What we want to know is what schemes are likely to deliver sustained benefits that justify the investment. Those benefits may well justify such investment, but the Government parade, as they always do, the fact that they have done something. They say that there is an evaluation. We know that it has not been sustained beyond 12 months. The Government do not talk about an evaluation that will assess whether exercise referrals work and in what circumstances because, lo and behold, they are happening in south Cambridgeshire.

Andy Reed: rose—

Andrew Lansley: I give way to the hon. Gentleman.

Andy Reed: I thank the hon. Gentleman for finally giving way. As he knows, I have a passion for sport and physical activity. Representing Loughborough as I do, I must not only engage in such activity, but take great pleasure in doing so. Does the hon. Gentleman accept that the last Government's record—up to 1997—was pretty atrocious, especially in relation to school sports? I admit that this Government took some time to recognise school sports' full value, but will the hon. Gentleman acknowledge that the investment now being made—two hours of sport per week within the curriculum, possibly four hours by 2010—will make an enormous difference to the future? Will he apologise for the last Government's record and confirm that enormous strides are now being made, while even greater advances are being achieved in adult sport?

Andrew Lansley: I am glad the House has been spared the need for a speech from the hon. Gentleman, but I do not accept what he has said. The Government said in 2001 that there would be two hours of sport a week for all school children. Currently 80 per cent. of children are getting those two hours, which include preparation and playground time but not actual engagement in competitive or any other sport.
	I do not dispute the value of the objective. My hon. Friends on the Culture, Media and Sport team have been first-rate proponents of the delivery of not just sport but competitive sport in schools, and I think it important too. Loughborough notwithstanding, my eldest daughter is reading sport and exercise science at Exeter, my old university; I think that Exeter will serve her rather well.

Nicholas Winterton: My hon. Friend is making an excellent speech. On Saturday, I visited the Bollington leisure centre in my constituency. Those in charge of the gymnasium told me that a number of general practitioners were referring elderly people to the gym on prescription, because their health would benefit. Does my hon. Friend approve of that? I believe that such prescription by GPs is a very worthwhile endeavour, and should be extended.

Andrew Lansley: I will pass my hon. Friend a copy of "Fitness 4 Health", a leaflet which advertises the south Cambridgeshire exercise referral scheme, supported by both the primary care trust and the local authority. In 2004-05, the 176 local health professionals registered with the scheme made 430 referrals. It was particularly important to those with type 2 diabetes.
	I entirely agree with my hon. Friend about the importance of such schemes; I do not underestimate it. I am merely saying that the Government should not get away with claiming that they somehow invented exercise referrals, or that they have evaluated them. The same things are happening elsewhere.
	We have not yet talked about obesity in children, but that situation is also deteriorating seriously. There has been a 50 per cent. increase in the proportion of boys with a body mass index over 30, and a 40 per cent. increase among girls. Our children are getting fatter faster than children anywhere else in Europe. That returns us to the point made by the hon. Member for Loughborough (Mr. Reed): we need more sport in schools, and also outside them. Conservative Members are committed to ensuring that sport receives lottery funding, but it must be increasingly well used.

Howard Stoate: I entirely agree with the hon. Gentleman that childhood obesity is the big issue that we must face, given a trebling in the number of obese children over the past 20 years. Does he agree that one way of tackling the problem would be a meaningful ban on the advertising of food that is high in fat, salt and sugar, which should begin at the watershed so that no advertisements for such foods appear until 9 pm? Parents and others understand what the watershed means, and could protect their children from such pernicious advertisements.

Andrew Lansley: I personally think that Ofcom has launched a very sensible consultation to which it is right for us to respond, but there is a bigger deal: enabling parents to construct a good diet for their children. That is absolutely central.
	Advertising might have a part to play, but getting the diet right, and parental control of children's diets, is instrumental. When the former Secretary of State launched the White Paper in November 2004, I said that it was wrong to have a simplistic traffic-light system and that it would be better to have a system that was geared to guideline daily amounts. The Government have now accepted that proposition. They abandoned what they said in November 2004 but so much time has gone by, in which so many retailers and food manufacturers have brought in competing systems, that we continue to have confusion. It would have been much better if the Government had listened to us in the first place and had put in place a system that was GDA-related and used traffic lights, and which could have commanded greater support in the food manufacturing community.

Kevin Barron: In relation to parents, children and food, the hon. Gentleman will remember the incidents in September at a school in Rotherham when some parents tried to defeat the healthy menu that had been introduced by feeding food through the school railings. Does the hon. Gentleman agree with his colleague, the hon. Member for Henley (Mr. Johnson), who serves as a shadow Education spokesman, and who declared:
	"I say let people eat what they like. Why shouldn't they push pies through the railings?"

Andrew Lansley: No, I do not. I think schools have a responsibility for the food that is provided at school—but, frankly, parents have an even greater responsibility.
	There is a great deal that we can do. There is not a lot of disagreement on this subject in the House. We want to make sure that there are fresh foods that are freshly prepared in schools—and if that is not possible as many schools do not have kitchens, technologies and opportunities are increasingly available for fresh food to be prepared elsewhere without it having to be cooked on site, and we should use them.
	Let us look at the Government's record on sexual health. There is an epidemic of sexually transmitted infections. That was not the case up until the mid-1990s, particularly because of the tombstone campaign—the 20th anniversary of the launch of that campaign by Lord Fowler and the then Government is a couple of weeks away. That showed what is possible when a national campaign is conducted that is designed not only to focus on those who are at risk but also to change the surrounding culture. Not only did we have the best record in Europe on prevention of HIV infection, but we had a substantial reduction in other sexually transmitted infections.
	What have we had since? Chlamydia is up 147 per cent; syphilis is up 1,653 per cent; and HIV infection is up 111 per cent. The Government have recently promised £50 million for sexual health campaigns but they are actually spending only £3.6 million on them. In the early 1990s, the then Government were spending £15 million a year in real terms on the sexual health campaign. That figure has now fallen below £5 million.

Graham Stuart: The failure of public health campaigns nationally and the failure to invest in sexual health campaigns is matched locally by deficits in the NHS. That has led to cutbacks in sexual health services in the East Riding of Yorkshire, which is suffering precisely the epidemic that my hon. Friend has been talking about. My constituents want to hear answers this afternoon from Ministers who have let the public down.

Andrew Lansley: That is precisely the point. When Ministers published the White Paper, they said that, in one respect, there would be ring-fenced budgets. That was supposed to be the case for sexual health, which was turned into one of their six priorities. The Department of Health—strictly speaking, I should say the independent advisory group—did its own survey. It went to 191 primary care trusts: 33 of them admitted that they withheld some or most of the funding; 51 said that they absorbed the entire allocation into their general budgets; and 31 said that they were withholding funding from chlamydia screening. On the latest data, only 36 per cent. of primary care trusts have been conducting chlamydia screening, but the figure for that is supposed to be 100 per cent. by March next year. The sexually transmitted infections record is disgraceful compared with that of the past.

Paddy Tipping: I am very interested in the reel of statistics that the hon. Gentleman has given. He seems to be advocating that targets are necessary: targets relating to sexual health and targets for the NHS. I thought he was against targets.

Andrew Lansley: The hon. Gentleman has not been listening. We are against top-down targets that impact on the services that clinicians provide. We are not against public health targets; I have never said that I am against public health targets.
	The last Conservative Government had targets.  [Interruption.] Perhaps Government Front Benchers would care to listen. Targeting ought to be an instrumental part of the performance-management process. It is not the job of the Department of Health to performance-manage individual hospitals, trusts and health care providers on the front line. It should be the job of the Government—when we are in government, it will be—to deliver on public health, so when in government we will set targets that we will impose on ourselves, and against which we will be measured. In 1992, Virginia Bottomley, the then Secretary of State, published "The Health of the Nation" White Paper, which was regarded as the model of its kind—the first public health White Paper from a major Government. Yes, it set targets, which was the right thing to do.
	The Government's teenage pregnancy target is another that they are not going to meet. We are well below the necessary trend; indeed, our teenage pregnancy rates are not only the highest in the EU15, but the highest by a long way. Yet out in the field—in places such as Bexley—family planning clinics are being withdrawn and emergency hormonal contraception is being removed from pharmacies. The teenage pregnancy budget in Coventry has been cut by 12.8 per cent., and 15 related posts are going to go.

Sarah McCarthy-Fry: rose—

Andrew Lansley: Perhaps the hon. Lady can tell us of similar examples in her own area.

Sarah McCarthy-Fry: On funding, surely the hon. Gentleman accepts that if his party had had its way, primary care trusts would not have had the additional funding that they received because his party voted against it.

Andrew Lansley: That is another example of the limited number of Labour MPs who trouble to come to our health debates not even listening. We have made it repeatedly clear that we have committed ourselves not only to resources for the national health service, but to ring-fencing public health budgets. We are fools to ourselves if we increase resources for the NHS, but do not ensure that such increased resources lead to primary prevention and awareness-raising, so that we can reduce future demands on the NHS.

Ann Cryer: Will the hon. Gentleman explain to the House this afternoon what advice he is going to give to the Government, so that they can prevent our constituents from having unprotected sex? Unless he can explain that, I am afraid that he is not getting to the heart of the problem.

Andrew Lansley: That, from a Government who abolished the Health Education Authority—terrific!—who have a record on public health of modest, limited expenditure on targeted campaigns, but who never do the thing that experience suggests is absolutely necessary: changing the culture and the climate.
	We do not need to look into a crystal ball—we have experience. There is a book showing that there was a time, in the mid-1980s, when a campaign changedthe culture regarding protection against sexually transmitted infections. The next campaign will not be the same, but we must have ring-fenced budgets that are, in part, used nationally to deliver such a culture change.

Peter Bottomley: The hon. Member for Portsmouth, North (Sarah McCarthy-Fry), who has a genuine interest in this issue, might like to consider that, by helping to change the associated culture, the number of instances of drink-driving by young men was successfully cut by two thirds in two years. Money matters, but so does the culture. Does my hon. Friend agree that if the Labour Members who keep intervening on him looked at the last two lines of the Government's amendment to our rather good motion, they would notice that the Government's justification for cutting funding for the south coast and elsewhere by about £400 per person is denied by that amendment, for which they will vote? According to that amendment, the differences in morbidity and mortality will be addressed by other issues. The Government might like to give that money to the south coast, so that we can keep our hospitals and accident and emergency departments and treat people where they want to be treated.

Andrew Lansley: I understand the point that my hon. Friend makes; however, he will forgive me if I do not take a long detour in that direction.
	It is absolutely right that we ring-fence public health budgets, and part of the reason for doing that is so that they can be set at levels proportionate to the measures and programmes that are proven to have effect, in order that we can deal with health care outcomes directly. That does not mean, however, that that is the only way of dealing with health outcomes—far from it. As colleagues in all parts of the House have made clear, in order to deal with poor health outcomes we must address a range of issues, such as relative deprivation, socio-economic status, poor housing, and diet and nutrition, among many others.
	My hon. Friend mentioned alcohol. Alcohol-related deaths have doubled in the past 14 years and there was a 30 per cent. increase in alcohol-related hospital episodes between 1997 and 2004. Professor Roger Williams, a leading hepatologist told me:
	"The situation is terribly worrying. We are seeing every week young women with end-stage or very severe liver disease and we never used to see as many before."
	Then there is drug abuse. The number of people using class A drugs frequently has gone up by a third, from 1.1 per cent. in 1998 to 1.6 per cent. in 2005-06. On cannabis, the Department of Health has had no influence on policy. If it had, Health Ministers would have persuaded their Government colleagues that sending the kind of messages they put out on cannabis use is deadly dangerous. There will be an epidemic of schizophrenia if young people in their teenage years—many with a predisposition towards that disease in such circumstances—continue to take cannabis at current rates.

David Burrowes: I share my hon. Friend's concerns about the effects of cannabis. Will he also highlight concern about the lack of attention given to alcohol abuse? The Department of Health's estimates show that about £1 of every£3 spent on accident and emergency treatment may be related to alcohol misuse. Is not it a scandal that the National Treatment Agency for Substance Misuse has no dedicated funding for alcohol rehabilitation and aftercare services?

Andrew Lansley: I agree with my hon. Friend, who makes a good point, but if he will forgive me I shall move on as I want to speak for only about 10 minutes more.
	When we consider infectious diseases, we find that HIV has more than doubled and that there has been a 20 per cent. increase in tuberculosis reports in England in two years. In 2001, Ministers promised a strategy on hepatitis C by the end of the year. It was not published until July 2004. According to the Government's estimates, a minimum of 200,000 people are infected with hepatitis C but are undiagnosed. Failure to treat them could lead to 100,000 patients with end-stage liver disease some years hence.

John Mann: As the hon. Gentleman knows, hepatitis C is primarily caused by intravenous drug use. In his discourse, will he outline precisely what his party's drug policy is, especially in relation to intravenous drug use?

Andrew Lansley: At the last election, my party was clear about our determination to put resources into drug rehabilitation and to present drug users who enter the criminal justice system with a clear choice: either the criminal justice system would take responsibility for them or they would move into drug rehabilitation.

John Mann: rose—

Andrew Lansley: No, I shall not give way again.
	What has the Department of Health been doing about infectious diseases over the last year? Statistics issued by the Department last week showed that between 2004-05 and 2005-06 its net expenditure on infectious diseases went down from £1.5 billion to£1.2 billion, which includes the 20 per cent. reduction in the budget of the Health Protection Agency. Given the agency's current work, one wonders how sensible that reduction was.
	The public health budget is not just for primary prevention, but for secondary prevention. The Government's amendment refers to bowel cancer screening. By the end of December, 500,000 people should have been screened through the new bowel cancer screening programme; the number will actually be only 100,000.
	Two years ago, the Government's White Paper described how pharmacies would be used to roll out new ways for people to access screening services. Only 1.5 per cent. of pharmacies across the country have been commissioned to provide local enhanced screening services. Only 26 per cent. of pharmacies have been commissioned to provide stop-smoking services. During the local elections I visited a pharmacy in Havering—in the constituency of my hon. Friend the Member for Romford (Andrew Rosindell)—and the pharmacist told me that they were in the middle of providing smoking cessation services but had been told to stop because the primary care trust had withdrawn the budget. It is all to do with finances.
	We have talked about the smoking ban. Rightly, we concluded that we might save 1,000 lives that way. The bowel cancer screening process might save more than 1,000 lives. Breast cancer screening saves perhaps 1,000 or 1,500 lives a year. What about abdominal aortic aneurysms? Where is the Government's action on that? Some 2,400 people with ruptured aneurysms go into accident and emergency departments every year; 50 per cent. of them die. What about men who are over 65? A Gloucestershire pilot—I do not know whether the hon. Member for Gloucester (Mr. Dhanda) is present—looked at a screening programme. It is straightforward and involves an ultrasound that is like the ultrasound that pregnant women have during the course of antenatal care. Research on that was published in 2002.
	The National Screening Committee said, yes, we should have such a programme. The Minister's predecessor said that there was going to be an action plan by the end of 2004. It is now the end of 2006. More than 1,000 lives are lost a year from ruptured aortic aneurysms, but there is no screening programme. The Government, through the White Paper, buy 1,200 health trainers, for which there is no evidence base. We have an evidence base for saving lives through a screening programme, but the Government are doing nothing.

Fiona Mactaggart: Will the hon. Gentleman give way?

Andrew Lansley: No, because I am about to conclude.
	In all the ways that I have described, public health has lacked priority and urgency. The Government produce document after document. There is a stack of them. I have a pile of them here and another pile back in the office. However, as Derek Wanless said, we need delivery and implementation, not more discussion. We need research so that there is an evidence base for what is being done. Derek Wanless has agreed with the Conservative party's policy. I said before the election that we need a Secretary of State for public health, not just a Minister for public health. We need the Department of Health to focus on public health. We need a ring-fenced public health budget and an enhanced chief medical officer's department. We need directors of public health, jointly appointed by local authorities and the primary care trust, who have those ring-fenced budgets—

Graham Stuart: Will my hon. Friend give way?

Andrew Lansley: No, I am about to finish.
	Those people should have the opportunity to use those budgets, using an evidence base, to deliver right across not just the NHS, but the public and private sector. As Professor Liam Donaldson, the chief medical officer, said in his report, which was published this July, we need the public health work force to know that it is supported in that way. He said:
	"There is strong anecdotal information from within the NHS which tells a consistent story for public health of poor morale, declining numbers and inadequate recruitment, and budgets being raided to solve financial deficits in the acute sector."
	Frankly, even since he wrote that, the reorganisation of primary care trusts, which Ministers said would not lead to a reduction in public health staff, has led to precisely that. More jobs have been lost among the small number of qualified public health staff. At the end of his article, Professor Donaldson said:
	"It is time for things to change."
	That is indeed the case. We need a Governmentwho are focused on public health, who bring the Department of Health's focus on to that, and who achieve that change. I commend the motion to the House.

Caroline Flint: I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
	"welcomes the Government's trebling of investment in the NHS by 2008 which is crucial to improving public health and tackling health inequalities; notes that this extra investment has enabled a huge expansion in preventive services including extending breast cancer screening to women aged 65-70 which has helped increase the number of breast cancers detected by 40 per cent. since 2001 and the first ever national bowel cancer screening programme which will detect around 3,000 bowel cancers a year when fully rolled out; acknowledges that this Government has done more than any previous government to help people give up smoking, including banning smoking in all workplaces and public places from 1st July 2007; further welcomes the help and support being given to people to live healthier lives including two million 4 to6 year olds now receiving a free piece of fruit or portion of vegetable, new healthier standards for school meals, clearer food labelling, new health trainers and NHS life checks; and recognises the unprecedented action this Government has taken to tackle the root causes of ill health and health inequalities including helping more people find work, lifting a significant number of children out of relative poverty and taking action to tackle poor housing."
	I ask the House to pity Opposition Members, who have to attempt coherent speeches after the confusion, hypocrisy and brass-necked cheek to which that we have just been subjected. The hon. Member for South Cambridgeshire (Mr. Lansley) springs forth with the zeal of a convert to public health, but his conversion to public health is rather like that of an Ebenezer Scrooge who has been awoken in 2006 to the need to changeby the nightmare of a Tory Christmas past. The nightmare reminded him of all that his party could have done with nearly two decades in power, and all that it did to undermine the public health of this country.

Graham Stuart: Will the Minister give way?

Caroline Flint: No.
	The Conservatives were the party that reduced the standards for building public housing; they removed nutritional standards for school meals; they offered a paltry £10 Christmas bonus to pensioners; and they had a cold weather payments system understood only by the weather man, leaving old people unprotected. Perhaps the ghost haunted the hon. Gentleman with memories of the tripling of child poverty and the doubling of pensioner poverty. Let us not forget that the Conservatives reintroduced mass unemployment into British society and presided over recessions and repossessions, with all of the health consequences that followed, thus consigning a generation to the scrap heap.
	Although the hon. Gentleman did not mention health inequalities today, he has done so in the past, so I give him credit for that.

Stephen O'Brien: It is in the motion.

Caroline Flint: I stand corrected. Perhaps the hon. Member for South Cambridgeshire did mention health inequalities in his speech. However, when his party was in power, the phrase never passed the lips of Tory Ministers, who preferred to talk about "health variations". Labour Members have not shied away from tackling the underlying causes of poor health, however challenging they are. There are no short-term fixes, but there is certainly no excuse for inaction.

Andrew Murrison: rose—

Caroline Flint: I will give way shortly, but let me make this point: is the epiphany that we have witnessed today the result of visits not only from the ghost of Tory Christmas past, but from the ghost of Tory Christmas present? After all, it was the Conservative leader who argued and voted against Labour's increase in national insurance to pay for increased investment in the NHS. I am sure that my hon. Friends were making a note of all the spending commitments that the hon. Member for South Cambridgeshire made during his speech. It is he and his leader who, after voting against increases in NHS investment, now tell their Back Benchers that more of the money should go to Conservative areas.
	Perhaps the hon. Gentleman is having sleepless nights over his other pledge on direct funding to areas with the greatest burden of disease. If that were implemented, the whole Government Front-Bench health team would receive more money for health for each of their constituencies, while each of the Conservative Front-Bench spokesmen would see less NHS money in each of their constituencies.
	Let us give Conservative Members some credit. Perhaps the conscience of the hon. Member for South Cambridgeshire has at last been pricked by the ghostof Tory Christmas future warning him that hisshadow Chancellor's spending rule for a future Tory Administration would lead to spending cuts of£17 billion for public services and huge cuts in the NHS. It is a wonder that the hon. Gentleman is any shape at all to come to the Dispatch Box, given the few nights of decent sleep that he must have had.

Andrew Murrison: Let us have a dose of reality, shall we? On the subject of health inequalities, perhaps the Minister remembers saying:
	"the gap in life expectancy and infant mortality has continued to widen since the target baseline. The life expectancy gap has increased by 1 per cent. for males and 8 per cent. for females. The gap in infant mortality has increased from 13 per cent. to 19 per cent."—[ Official Report, 25 October 2006; Vol. 450, c. 1961W.]
	Will the Minister also stop wasting taxpayers' money, such as the £20,000 that she spent on the silly advert on health inequalities that she placed in the  Health Service Journal, and put the money where it can really do some good?

Caroline Flint: It would be very easy to think that we could come to power and, with a wave of the wand, rectify all the unnecessary damage that the Tory Government did in nearly 20 years in power. If one examines the various reports produced during the Tory years—the Black report was just one—one sees that a widening health inequalities gap was being identified in the 1980s— [Interruption.]

Mr. Speaker: Order. Let the hon. Lady speak.

Caroline Flint: We have been very honest and up-front about the widening gaps. Action must be taken to put things right, and I shall make some points about the matter later in my speech.

Fiona Mactaggart: My constituency represents a clear example of how a determined focus on tackling health inequalities can begin to produce results, using the health trainers about which the hon. Member for South Cambridgeshire (Mr. Lansley) was so scornful. When I was first elected, the health inequality—the gap in life expectancy—between Slough and the rest not only of the south-east, but of England and Wales, was growing. It continued to grow in 1995, 1996 and 1997, but since then it has declined and begun to narrow. That has happened because we in Slough have used health trainers well. Our focus is delivering a reduction in health inequalities, so such a thing can be achieved elsewhere with that kind of determination on the part not just of individuals, but of companies.

Caroline Flint: My hon. Friend makes an important point. Progress is being made in Slough and in other parts of England. Part of our work at the Department of Health is ensuring that we provide the correct information and advice on how to tackle some serious and challenging targets.
	When we were elected in 1997, we faced chronic underfunding of the NHS, increasing waiting lists,staff shortages and the disarray inherited from the Conservative party. I make no apology for the fact that we had to give our attention to that situation and that it had first call on our resources. None the less, we are the first Government to appoint a Minister for Public Health and to work across government to put right the Conservatives' neglect. We are the first Government for decades to tackle the root causes that undermine health and well-being and to give leadership in response to the nation's concerns.

David Burrowes: The Minister talks about pity and inequality, but does she not pity people in the north-east who are dependent on alcohol? Of every 102 people who need treatment for alcohol dependency, 101 cannot get access to it in the region. What will she do to extent the remit of the National Treatment Agency for Substance Misuse to alcohol?

Caroline Flint: I do not think that people need pity. They need action, and the north-east provides an interesting example of what we have done. We have mapped what treatment is available, and it is clear that there are gaps. That is why, with the NTA, we have provided models of care for alcohol treatment. It is why, just in the past few weeks, with St. Georges, university of London, and Newcastle university, we have initiated a trailblazer programme of brief interventions for people who are drinking in a way that is hazardous to their health. In that way, we are building the evidence base for why action is necessary and what practical action needs to be delivered on the ground. Different responses are required for chronic alcoholics and for those who go out binge drinking on Friday and Saturday nights.
	Tackling public health is bigger than having responsibility for the health service. Through the new deal we have reduced unemployment by helping1.5 million people into work, which I believe helps to improve the quality of people's lives.

Andrew Gwynne: My hon. Friend spoke about Tory Christmas past and Tory Christmas present, but for my constituents there were no Tory Christmas presents. Through the winter fuel allowance and the Warm Front grants, we have come a long way from the days when Tory Ministers told pensioners in my constituency to knit woolly hats.

Caroline Flint: My hon. Friend is absolutely right. The Warm Front scheme has helped thousands of families on low and fixed incomes to install central heating or upgrade old and inefficient heating systems; the winter fuel allowance has been a boost to pensioner households; and Sure Start has been vital to starting children off on the road to better health. All those initiatives have had an impact on health, and all have been rejected by the Conservatives, time and again.

Rob Marris: May I congratulate my hon. Friend and the Government on something that the hon. Member for South Cambridgeshire (Mr. Lansley) recognised only grudgingly? The national bowel cancer screening programme was started in Wolverhampton and is, I believe, the first health screening programme in the world to cover both men and women.

Caroline Flint: I thank my hon. Friend for his intervention. I know that he will work to ensure that the programme is working properly in his area. It is easy to pour scorn on such initiatives, but that programme is a world first—just one of many that we are achieving in public health.

John Bercow: Given that alcohol abuse is fuelling violence crime and that reducing addiction is crucial to reducing reoffending, will the hon. Lady tell the House what discussions she has had with the Home Office about the fact that prisoners at Grendon and Spring Hill prisons in my constituency who have committed alcohol-fuelled crimes cannot get access to publicly funded treatment, which they desperately need?

Caroline Flint: I regularly have conversations with Home Office colleagues. I am happy to follow up the case that the hon. Gentleman raises. Part of our work with St. Georges, university of London, and Newcastle university deals with interventions, whether in a police cell or in an accident and emergency department, when people have drunk too much for their own good, which could result in antisocial or seriously violent behaviour. We are trying to find ways of capturing those moments to redirect people into programmes—not necessarily programmes suitable for chronic alcoholics, but programmes for those who drink hazardously in a way that regularly affects their behaviour.
	I can tell the hon. Gentleman that recent figures from the British Beer and Pubs Association indicate that alcohol consumption per head has fallen by 2 per cent. over the past 12 months.

David Burrowes: Not for children.

Caroline Flint: That is the first decline in nine years, but I am not complacent. There are concerns about children and young women. However, the proportion of 16 to 24-year-old women who had drunk more than six units on at least one day in the previous week has fallen to 22 per cent. from 28 per cent. in 1998. We must be cautious about these statistics, but there seems to be a growing awareness of the impact of alcohol. I hope the hon. Gentleman will agree that our campaign to point out to young people that although alcohol makes them feel invincible, they are actually very vulnerable under its influence, will strike home. The feedback from that campaign has been extremely positive.

Graham Stuart: The Minister announced two years ago that £50 million would be spent on public health campaigning for sexual health. Recently she announced that only £4 million would be spent. Does she share my disappointment at that change? Does she think that £4 million is adequate and that no improvement could be gained from greater expenditure from budgets that have already been allocated?

Caroline Flint: More to add to the shopping list. I am interested in what works and what is effective. That is why our campaigns in the Department are not only focused on what we do nationally, but are much more targeted at the groups that we most want to reach. We provide PCTs and community organisations with materials that they can use locally. We also work through the magazines that young people— women and men—read, which have an added reach beyond that of TV campaigns and radio adverts.

Simon Burns: On targeted public health information, particularly to young people through magazines, can the Minister explain why, if that approach is such a good one, the incidence of various sexually transmitted infections has increased so dramatically? The tombstone campaign in the late 1980s and early 1990s was a high profile campaign to get a strong message across, and right up until 1995-96 we saw a dramatic decrease in levels of HIV and other STIs because of condom use, as opposed to the dramatic increases that have taken place since the introduction of the targeted approach.

Caroline Flint: I shall be happy to deal with that in more detail later.
	In 1994-95 under the previous Conservative Administration UK health departments reviewed their health promotion strategy and came to the conclusion that community-based and self-help groups were often better placed to develop targeted health promotion than Government or their agencies. I believe we need a mixture of both, but I shall come to sexual health later in my contribution, if the hon. Gentleman will be patient.
	Public health, as I said, is not just a matter for the Department of Health. Individuals, communities, employers, public services and the voluntary sector all have a part to play in shaping health and well-being, but Government must be willing to lead.

Diana Johnson: Will my hon. Friend join me in congratulating the jointly appointed director of public health in Hull, who was appointed by the local authority and the PCT, so that there can be joined-up thinking to ensure that public health improves in Hull?

Caroline Flint: Indeed, and I am pleased that in Doncaster we are following the same route. For the past couple of years we have encouraged closer co-operation with local government. That is starting to pay dividends. One aspect of that is the joint appointment of public health directors at a local level, which can only add to what we can achieve beyond health and in the wider community.
	I am sure that hon. Members in all parts of the House will agree that today's challenges are very different from those of 100 years ago. In the 19th century and early 20th century, most premature deaths were due to infectious illnesses, often striking people down in infancy or in the prime of life. In 1854, 600 people died from cholera caught from the infected water of the Broad street pump in London. But times change and the challenges are different today. We are living longer, so the diseases of middle life and old age are more pertinent now than they were 100 years ago.
	Thanks to the investment by this Government, we have made changes that are improving public health. Life expectancy has continued to increase both for males and for females in England as a whole, and for those living in communities with the worst health and deprivation. Sixty per cent of those communities—the spearhead areas—are on track to narrow the life expectancy gap between their areas and England as a whole by 10 per cent. by 2010. The gap that meant that someone was more likely to die of heart disease or cancer if they were poor is narrowing.
	The NHS and local authorities are key players in tackling health inequalities. For the first time ever, the issue of health inequalities is one of the Department's top six priorities for the NHS, and from next April it will be a mandatory target for local authorities through local area agreements. The figures for children dying before their first birthday are the lowest ever, and the latest figures suggest that the infant mortality gap between our poorest families and the rest of the population has stopped widening. We cannot be complacent, as I said, but there are indications that the efforts of many people on the front line are starting to have an impact.
	None of this is accidental. One lesson that we have learned is that to prevent these problems recurring from generation to generation we have to intervene early in life. "Healthy Start" and the healthy schools programme are two examples of this. "Healthy Start", which was launched nationally last Monday, is the first major reform of the world war two welfare food scheme to meet modern dietary requirements. The healthy schools programme lays down the building blocks for our young people. Last year, we decided that we needed to highlight and prioritise healthy eating and physical activity in order for a school to become a healthy school. It is a voluntary programme, but more than 80 per cent. of schools have chosen to participate and are reporting real benefits, including the provision of at least two hours of sport and physical activity. That figure was less than 30 per cent. in 1997-98, when we came into government, so we are making progress.

Jeremy Wright: I am sure that the Minister agrees that one of the most effective ways of combating childhood obesity is to persuade children to walk to school and to engage in more outside activity in their leisure time. Does she accept that one of the reasons why that does not happen is that parents do not trust their children to play outside because they do not regard it as a safe environment? Is that something else that she would like to talk to her Home Office colleagues about?

Caroline Flint: Of course, tackling antisocial behaviour is a major part of tackling that fear. I have always said that antisocial behaviour is about the victims, who are often children and young people. This is not an anti-child or anti-young person measure—it is about creating the right environment for children to play outside. The Department is researching the reasons why people come to accept the basis for change. That is important. It is not just up to me to have a few bright ideas every day—we have to back it up. As the hon. Member for Rugby and Kenilworth (Jeremy Wright) suggested, we have found that parents who are asked about physical activity and what stops them letting their children play outside say that safety is one of the issues and that they therefore trade off playing outside against watching TV or playing computer games. That is why our work with the Home Office, local government, sports clubs and community organisations is so important in creating an atmosphere that is conducive to encouraging people to be more healthy in their everyday lives.
	Good voluntary initiatives do not end with the public sector. The food and drink industry has been working closely with the Food Standards Agency to reduce the levels of salt in processed foods, and excellent progress is being made. Many manufacturers and retailers have accepted the need for simpler front-of-pack labelling of salt, sugar and fat in food. When I came into this job, that was not a unanimous view, and they were discussing whether such labelling was suitable, but we are now at a stage where the industry has signed up to recognising its importance. We have agreed with the industry that there will be independent research to see which system works best for consumers. Early indications show that shoppers have found the multi-coloured, or traffic light,system most useful when they are running busy lives and trying to choose between one shepherd's pie and another. We will be monitoring the situation and providing independent research with the FSA whereby we can all agree on the best outcome.
	The Government's 2005 election manifesto pledged to restrict the advertising of high-fat, high-salt and high-sugar foods to children. As has been mentioned, Ofcom recently announced its intention to restrict advertising, and we will keep a watch on that situation. That is another example of Government leadership. We made the case that there was an imbalance in the relationship between the advertising of high-fat, high-salt and high-sugar foods and children, and we wanted the regulator to apply itself to the problem. We will see what happens, and how the measure changes the balance, but we have left open the option of legislating in future, if we think that it is the right thing to do.
	Money and legislation have never been the Government's only tools. When a consensus can be reached, we may sometimes make quicker progress towards common goals through voluntary means, and we are open to discussions on those voluntary means. I am proud of the fact that the Government took a lead and contributed to a shift in emphasis, and to a consensus in favour of healthy choices and healthy living.
	The Government are impatient to ensure fewer needless deaths. We have a right and a responsibility to intervene more decisively, when that is required. The Health Protection Agency, which is unique and a true world leader, is a one-stop shop dedicated to protecting the general public's health from infections, chemicals, poisons and radiation. We are the first country in the world to introduce the meningitis C vaccine, and we immunised 13 million children in year one. Deaths from group C meningococcal disease have fallen by90 per cent. in all age groups, including among those not offered the vaccine. Thousand of children's lives have been saved and 10,000 cases have been averted as a result.
	We have continued to promote the measles, mumps and rubella triple vaccine, which saves lives, and which has been shown repeatedly in research to be the safest method of gaining mass immunity to measles, mumps and rubella. I hope that all Opposition parties will support the best medical advice on that important issue. We continue to improve the protection that we offer to children in this country. In September this year, pneumococcal vaccine was added to the vaccines routinely offered to babies. It protects against a serious form of meningitis, and we expect it to save many children's lives every year. Our flu vaccination programme will offer 15.2 million vaccinations this winter, which is 1 million more than last winter.

Andrew Murrison: Will the Minister remind the House of why, for three years in a row, the Government have failed to deliver the flu vaccine on time?

Caroline Flint: As the hon. Gentleman will know, this year there was a manufacturing problem with the vaccine that no one could have foreseen, and we had to deal with that. On vaccine delivery, I remind him that we negotiate the total amount of vaccine, based on what we identify to be the need of the population— and, I must say, we have allowed the vaccine to be provided on the NHS to an ever widening group of people. It is up to general practitioners and primary care trusts to make their orders for vaccines.
	Of course, we want to improve the system, but the picture varies across the country. In many places, the authorities are on top of the issue, and district nurses provide the vaccine in people's homes. In those areas, the rates of vaccination are increasing. However, it seems that other areas are not on top of the problem, and we have to understand that. We should support GPs, and we are working on doing that. That is why my right hon. Friend the Secretary of State has asked for a review of the issue, to see how we can improve. However, that should not take away from the positive progress that we have made. We are considered to be one of the world leaders in flu vaccination, and other countries rightly look to us, and our developments in that area.
	Our extended breast cancer screening programme, which now includes 65 to 70-year-olds, has screened over 600,000 more women, and it saves 1,400 livesa year. As my hon. Friend the Member for Wolverhampton, South-West (Rob Marris) said, the bowel cancer screening programme, which is a world first, will detect some 3,000 cases each year within three years.

Sandra Gidley: I welcome the extension of breast cancer screening to an older age group, but does the Minister accept that the highest rate of breast cancer is among older women who are not screened? What is she doing to raise awareness among people in that age group?

Caroline Flint: We continue to consider how we can improve awareness. We must make sure that we are not complacent about providing a screening programme; we should make sure that women of all ages who are currently eligible take advantage of the screening programme. I will pass on the hon. Lady's comments to the Minister of State, Department of Health, myright hon. Friend the Member for Doncaster, Central (Ms Winterton). We keep all such issues under examination, and, obviously, we want to do the best that we can for women in all age groups, as far as priorities and resources allow.

Several hon. Members: rose—

Caroline Flint: I must make progress, because I want to give some time to sexual health issues. We have addressed the subject of prevention and the lifestyles that put the public at greater risk. Things have changed since the 1980s, and we have to face up to the ignorance surrounding HIV and AIDS. Today, images of people dying are not as prevalent on our television screens. We have to consider how people perceive HIV and AIDS. That is partly because we are a world leader in medical support and treatment. However, the consciousness of young people has changed, so we must deal with different attitudes to HIV, AIDS and other sexually transmitted infections.

Simon Burns: Does the Minister accept that today's generation is too young to remember that education programme? Young people are ignorant of the serious dangers of HIV, so the use of condoms and other measures have not succeeded in keeping the levels of sexually transmitted infections and HIV down. It is therefore crucial that we do not use targets which, statistics show, are ineffective, but develop a hard hitting campaign so that everyone understands the problem.

Caroline Flint: It is not an either/or issue. Targeted work is helpful in gay and African communities, but the hon. Gentleman will agree that our most recent campaign—"condom essential wear"—is important, too. We want people to think about taking condoms with them on a night out, as they are as essential as their car keys, lipstick and wallet, and are a good way of preventing sexually transmitted infections. The message applies to everyone—by using a condom one reduces the risk of contracting not only HIV but chlamydia and several other sexually transmitted infections. I welcome the hon. Gentleman's support, and I hope that he will encourage his hon. Friends to support our campaign, as some of them have not been open about the need for such sex education.

Nadine Dorries: rose—

Caroline Flint: I will not give way, as I wish to make progress.
	Our chlamydia screening programme has screened more than 100,000 young people—an increase of 40,000 on the previous year—and we have set targets to ensure that by 2008, everyone referred to a genito-urinary medicine clinic is seen within 48 hours.
	I am proud that the Government have moved a step further in their attempts to support people who wish to give up smoking. We promoted smoking cessation on the NHS, which has made a major contribution by persuading 1.2 million people to end their smoking habit since 1998. From 1 July next year, all enclosed workplaces and public places will be smoke-free, which is a landmark step that we were persuaded to take by our hon. Friends and other hon. Members. However, we triggered the debate by saying that we were going to legislate, thus providing the platform for the free vote on 14 February. I echo my hon. Friend the Member for Dumfries and Galloway (Mr. Brown) in quoting Professor Alex Markham, who described that landmark step as
	"the most important advance in public health since Sir Richard Doll identified that smoking causes lung cancer fifty years ago."
	The motion offers false promises. The Opposition want improved services, but they refuse to support any action to tackle local deficits. They claim to back local health professionals to improve public health, but they oppose every local reconfiguration of service. They have identified a list of public health issues, without offering the means to tackle them. In one breath, they demand the loosening of Whitehall control, but in the next they demand the ring-fencing of funds for public health from the centre. The Conservatives face all ways, and they do everything that they can to avoid any long-term decision that involves change in any locality. The hon. Member for South Cambridgeshire has shown today that tough decisions are still something his party is unwilling to make. We are leading a huge cultural change in health, by moving from a crisis service dominated by hospitals to a system in which prevention and the promotion of health and well-being take their legitimate place in good health policy. We make no apology for setting targets to reduce health inequalities, or for taking action across government to achieve them, whether by improving housing, home insulation, school diets and opportunities for sport and physical activity, or by reducing unemployment. We are dealing with the problem, and we are getting on with the job and producing results. That is the difference between our party and the Opposition.

Sandra Gidley: I welcome the opportunity to discuss public health, which is undervalued and under-discussed. I wish to set our debate in the context of equality, because while overall health has improved, health inequalities remain. Whether we look at geography, social class, gender or rage, there are inequalities galore.
	I may not have heard the Minister correctly, but I thought I heard her say that inequalities were narrowing. In a parliamentary answer in October this year she said:
	"In England average life expectancy for males is 76.6 and for females 80.9, in the spearhead group it is 74.6 for males and 79.4 for females. The slower rate of improvement has led to a widening of the relative gap in life expectancy between England and the spearhead group."—[ Official Report, 25 October 2006; Vol. 450, c. 1962W.]
	That strikes me as very disappointing. Given the extra money put into the spearhead PCTs, I would be interested to know whether it reached through to public health budgets. If so, the money is clearly not yet being spent in the most effective way. When the Minister sums up, I hope that we will hear what is being done about that problem. Some of the spearhead PCTs are back on track, but more than 30 are currently off track to meet their share of the 2010 target.
	It is useful to take a cradle to the grave approach. I hope that the Government will accept that good health starts in the womb and that good antenatal care is vital. Although antenatal care is a key factor in the spearhead PCT programmes, the Minister will know from a previous debate that in some areas, mine included, antenatal education has been axed as a result of deficits. The explanation put forward is that mothers have a one-to-one with their midwife to discuss birth options, but surely the Minister would accept that one of the wider benefits of antenatal classes is ensuring that women receive good targeted public health messages. Some of them are about diet and exercise, which can help to get children off to a good start. If the Minister would commit to investigating the demise of antenatal classes, many people would be thankful.
	It is at birth that inequalities begin. Recent figures show that a baby boy born in Kensington and Chelsea can expect to reach, on average, the ripe old age of 82.2. In Glasgow, however, the age falls to 69.9. That is a devolved matter, so to stick to the English exampleof Manchester—closer to home for some Health Ministers—the age is 72.5. Women are a little luckier as the comparable ages are 86.2—an extra four years over the men—in Kensington and Chelsea, 76 in Glasgow and 78 in Manchester.
	After the birth of their child, mothers have to make a choice about feeding and it is widely acknowledged that breast feeding is best. Again, it is strongly associated with social class. Figures comparing breast feeding rates between 2000 and 2005 show that the overall rate has fallen—and mostly in the lower social classes. I welcome the new scheme for food— [Interruption.] Yes, healthy start is right, and I welcome the healthy start scheme, but surely alongside it there should be some targeted information about healthy breast feeding.

Shona McIsaac: There is.

Sandra Gidley: The hon. Member for Cleethorpes (Shona McIsaac) intervenes from a sedentary position, but the information that the Minister sent me shows no evidence that there is such information. I look forward to seeing it, as providing it is an opportunity worth taking.
	Another problem for the Minister to deal with is the World Health Organisation code on milk formula. We all know that advertising of formula is banned, but there are few restrictions on follow-on formulae. Some baby milk manufacturers use misleading adverts, making it difficult to see that they are actually advertising follow-on formula milk. I suggest that some of the messages coming through to women from parenting magazines, which are read by many, are counter-productive.

Steve Webb: Although I welcome my hon. Friend's comments about encouragement for breastfeeding through the healthy start programme, is she aware that it includes vouchers for powdered milk? Does not that send mixed messages in the context of encouraging breastfeeding?

Sandra Gidley: It sends a mixed message, but it is better than the welfare food scheme that preceded it. Under that, I believe that one could not spend the vouchers on anything but milk.

Caroline Flint: In answer to the point that the hon. Member for Northavon (Steve Webb) made, we had to strike a balance with an individual's right to make decisions—and, clearly, breastfeeding is not possible for some women for several reasons. However, we are phasing out the further discounted infant formula that used to be available in our baby clinics so that we can focus more on promoting breastfeeding.

Sandra Gidley: Sure Start has been mentioned. It is easy to "knock, knock, knock" in such a debate—and plenty of material exists for that, as my Conservative colleagues demonstrated—but we must pay tribute to schemes that have worked well.

Ivan Lewis: There is a "but" coming.

Sandra Gidley: No, there is no "but".
	I pay tribute to the Sure Start scheme. My only criticism, which is mirrored throughout the country, is that a ward in my constituency has a deprived area, but because it is a large ward that also encompasses an affluent area, interventions in the deprived area were obtained only through a little jiggery pokery. However, we got there.
	The Government's commitment on school nurses is interesting and I welcome it. It appears to be an about-turn. School nurses, especially those based in secondary schools, are well placed to provide much information, but figures for them were not collected until recently. Answers to a parliamentary question in May showed that, of the 309 PCTs that existed then, 103 did not employ a single qualified school nurse. I appreciate that the target is not meant to be reached until 2010, but clearly much work remains to be done, and it would be interesting to learn how it will be made a priority.
	Although the Minister was positive about the meningitis vaccine, childhood vaccination rates have fallen. That is probably partly due to the adverse publicity surrounding measles, mumps and rubella, but I hope that we shall learn in the wind up how the issue will be tackled.
	Other inequalities that have not been mentioned include those in dentistry. The British Association for the Study of Community Dentistry surveyed 5-year-olds in 2003-04. There was a sevenfold difference between PCTs with the best dental health and those with the worst. People in social classes 3, 4 and 5 are three times more likely to lose their teeth than those in classes 1 and 2. Given that in many parts of the country it is difficult for children to gain access to a national health service dentist unless their parents go private—some PCTs have recently put a stop to that—what are the Government doing to improve dental health and the public health messages about oral health in young children? Many parents simply cannot access an NHS dentist, although I appreciate that provision is patchy geographically.
	Let us consider the growing problem of obesity—perhaps I should not have put it in that way. The figures are stark. The British Medical Association estimates that there already 1 million obese children under 16. If the trends continue, one fifth of boys and one third of girls will be obese by 2020. I welcome the moves to restrict food advertising, but that does not give the complete picture because societal influences are far more complex than that. The "McDonald's mothers" have been mentioned, and it is not helpful when politicians, whatever their party, claim that there is nothing wrong with feeding pies through the school gates.
	There is clearly a big educational task. Perhaps there is a way to use Sure Start or ante-natal classes to ensure that mothers are better equipped to feed their families healthily. In schools, they often do not receive the necessary education on providing a healthy diet.

Diana Johnson: Does the hon. Lady deplore the proposal by her Lib Dem colleagues in Hull to remove the free healthy school meals in all our primary and special schools? Those meals give our youngsters a very healthy start.

Sandra Gidley: I cannot really answer for my colleagues in Hull— [ Interruption.] I do not know the full story. It might have been prompted by a funding problem from central Government— [ Interruption.] What would hon. Members expect me to say? It would be unfair to comment on that situation when I do not have the full facts.
	Much has been said about sport, and I want to take issue with what the hon. Member for South Cambridgeshire (Mr. Lansley) said about the need for a lot more competitive sport. Those children who are a towards the end of the queue when the teams are being picked soon get the message and decide that they do not want to exercise because they do not want to make fools of themselves. That is not a positive experience. I have a pet hate about school sports days. Children who have little sporting ability in the traditional sense are often forced to enter races and be publicly humiliated.

Peter Bone: Will the hon. Lady give way?

Sandra Gidley: I will not give way at the moment. I want to finish my point.
	If a child cannot read, they are not put on a stage and made to stumble through the alphabet or a passage of Shakespeare, yet little thought is given to the children who do not excel at sport. Too little thought is given to other ways in which children can take exercise healthily and find a method of exercise that is suitable for them. That could involve dance, games and all sorts of other things. I would ask that we try to get away from competitive sport in schools and think about increasing exercise and activity. This is happening more and more, but I worry when I hear people saying, "Let's get back to good old hockey and football and other competitive sports."

John Mann: Is the hon. Lady aware that one of the great successes in school sports under this Government is that the biggest increase in participatory sport in primary schools has been in the use of non-competitive climbing walls? Schoolchildren of all shapes and sizes are using them in increasingly large numbers in our primary schools.

Sandra Gidley: I am pleased to hear that, because that is the kind of diversity that we should be encouraging. Children often want to try something new and different, and they could be hooked into exercise in that way. The traditional patterns work against that. Many adults feel that exercise is not for them because they were made to play team sports at school, rather than being encouraged to find a form of exercise that suited them—

Peter Bone: Rubbish.

Sandra Gidley: The hon. Gentleman says "Rubbish", but this is well documented—

Peter Bone: Give way, then.

Sandra Gidley: I will give way.

Peter Bone: I remember watching my youngest son run around a running track and come last in his race, but that did not stop him. It encouraged him to go further, and he is now a pilot in the RAF. The hon. Lady is talking complete bunk.

Sandra Gidley: I am not quite— [ Interruption.]

Madam Deputy Speaker: Order. Could we have just one debate, please?

Sandra Gidley: I am not quite sure that coming last in a school race is necessarily a proven route to becoming a super fighter pilot in the RAF, but I am willing to be persuaded.
	It would be useful if we could look at ways of increasing the facilities for families to engage in sport together. It is often a positive experience for families to exercise together. Recently, I went to a "Skip to be fit" session at one of my local schools. Everyone has done skipping at school, but this involved digital skipping ropes, and the children were quite excited. The emphasis was on learning to skip on a six-week programme with a personal improvement assessment at the end of it. The children were not measured by their peers, but by themselves. Such personal improvement initiatives are much more positive and inspiring for children than those in which their performance is compared with that of others.
	I was intrigued by the fact that the Government have spent £27,000—quite a lot of money—on pedometers. I have several pedometers, all of which seem to register different things. Most people wear them for two or three days and then chuck them into a drawer. What evidence base prompted that purchase? What analysis has been made of the cost-effectiveness of pedometers? We frequently talk about evidence bases: a new medicine cannot be licensed without a convincing evidence base. However, it seems that many well-meant public health interventions do not have an evidence base. With the varying inequalities in different parts of society, a little evidence about what works in different socio-economic or ethnic groups or on a gender-specific basis would be useful.

Andrew Murrison: Does the hon. Lady agree that although £27,000 is a lot of money, it is probably better spent than £20,000 on a piece of soft propaganda in the  Health Service Journal? In the context of public health, does she agree that it is important to ensure that public money is spent in a reasonable and worthwhile way?

Sandra Gidley: It strikes me slightly that the  Health Service Journal is preaching to the converted. An evidence base is needed to decide whether that is a more effective use of money than pedometers. I do not have the answer to that question.
	I now want to move on to sex education. We have heard statistics bandied about on the subject today. A few years ago, the Select Committee on Health undertook an extensive inquiry on sexual health, and one of its recommendations, which is also one of my party's recommendations, is that sex education should start at primary school. Children at that age do not need to know everything, but it is important that they start to talk about relationships, which are an integral part of sex education. What conversations has the Minister had with her ministerial colleagues about that?
	Teenagers to whom we have spoken say that teachers are often embarrassed about discussing sex. Logically, geography teachers are interested in geography, so that is what they teach, but schools do not have specialist sex education teachers—unfortunately, geography teachers' attempts to teach sexual health were often slated. Will the Minister consider having properly trained, expert teachers, who are not embarrassed by the subject, delivering that part of the curriculum? The input of parents, who are keen to know what their children are learning at school, might also be useful.
	Since 1996, gonorrhoea rates have increased by50 per cent.—by nearly 61 per cent. in men—syphilis rates have increased by more than 2,000 per cent., and chlamydia rates by 197 per cent. Disappointingly, despite the chlamydia screening programme, even the last year-on-year increase was 4 per cent. Although the screening programme is welcome, its roll-out around the country seems to have taken quite a long time. Why does that programme screen 14 times as many men as women— [Interruption.] Some of the early statistics show that it did. The disease is carried in equal numbers and most women are infected by a man. What has been done to address that inequality and to improve access to screening?
	The latest sexual health awareness campaign is aimed at 16 to 24-year-olds. In an earlier contribution one hon. Gentleman—I shall not embarrass him by mentioning him by name—claimed that the campaign was effective because his children of that age watched the relevant programmes, but it neglects the older age group, among whom there has also been a significant increase in sexually transmitted diseases. I have in mind the generation who have had a long-term relationship, have split up, are back on the circuit, although I hate to call it that, and are sexually active again—presumably they were sexually active during marriage, so perhaps I should say that they are introducing themselves to new partners the second time around. They may not have appreciated the messages the first time, may have forgotten them or may have thought that they applied only to the young. What is being done to address that group?
	The point was made that sexual health clinics for young people have been cut because the earmarked funding has not reached the front line. The 48-hour target for accessing sexual health services has not been met. The Health Protection Agency said in August that it was being met in 57 per cent. of cases, but we used an intern to do a mystery shopper exercise over the summer months and the figure for access was 31 per cent. Clearly, there is some way to go before that target is met. What is being done to achieve that?
	Vaccinations have been mentioned, and a promising new vaccine will reduce the rate of cervical cancer. A decision on it is likely to be made in February. What discussions has the Minister had on vaccinating young women in particular? Can she say at this stage when a targeted vaccination programme for cervical cancer is likely to be rolled out for young people, and what age group it will cover?
	I mentioned the sexual health inquiry by the Health Committee. The young people that it talked to referred to strong links between their behaviour and other factors and various pressures. There was peer pressure and media pressure, but one of the biggest determinants of whether people had unplanned sex was probably the use of alcohol, which is the most commonly abused drug. Children are drinking at an earlier age. Government figures show that the cost of alcohol-related harm is approximately £20 billion a year. The national alcohol harm reduction strategy was launched a year ago in a blaze of publicity, but some of those key commitments have not been met. The audit of treatment services has not been finalised and no targets have been published. Only one in 18 people who need treatment get it. That masks a huge regional variation because in the north-east only one in 102 people who need alcohol treatment services can access them.
	Alcohol Concern has called for the Treasury to have a public service agreement with the Department of Health and the Home Office. It also wants targets because it feels that things will not be taken seriously unless they are set in the same way as they are for drugs.

David Drew: Gloucestershire has an alcohol arrest scheme—I shall not call it by its acronym. It works in the same way as a drug treatment and testing order, and is very successful. For some time we have been asking for that scheme to be national. Does the hon. Lady agree that it is just the sort of scheme that should be taken forward so that we can try to deal with the issue when people are most acutely aware of the problem that they cause, which is when they are in the cells? If they take advantage of the help offered by the scheme, they realise that it has a high evidence-based result in dealing with alcohol problems.

Sandra Gidley: That sounds good to me, but I think that the hon. Gentleman should address his remarks to the Minister, who has the power to do something. I wish him luck, if the project really is evidence-based.
	The problem with planning alcohol services is that there is no idea of which people need treatment, what treatment they need and where they are clustered. Unless that is monitored as it is for the purpose of drugs services, it will be impossible to develop alcohol services in the same way. Information on progress would be most welcome.
	The British Medical Association is concerned about the threat to public health specialists from recent reconfigurations. It is feared that, because of deficit recovery plans, primary care trusts will seek to reduce rather than increase the number of consultant public health posts. It is probably too early to predict the number of displaced public health clinicians—the information is unlikely to be available for a few months—but may we be reassured today that the specialists' work force will not be reduced?
	What is the way forward? We need a greater evidence base. Statistics are finally being collected, which will help us to target interventions, but there is still far too little evidence about what really works. Links with education need to be strengthened so that children can build on personal, social and health education at school, and are educated for life. We also need a wider and more flexible use of the work force. There are a good many people with access to the public, such as nurses, health visitors and midwives. Pharmacists were mentioned earlier. I probably speak with a small amount of self-interest, but in pharmacy staff we have in-built health trainers who do not need to be trained themselves. Some are already being used, but the opportunity is not yet being maximised.
	Another problem is that when services are commissioned, the commissioners often do not think about the wider public health benefits. Evidence relating to the new contract shows that what is being commissioned is pretty much what was in place before, and that the opportunity to pay for more services has not been grasped.
	We should be clever in our use of the media. The Minister spoke of links with local government, but they could be stronger. In many instances the quality of housing is still far too low, and housing is one of the main determinants of future health. Transport is important, too. It has been demonstrated numerous times that when cycle lanes are introduced children cycle to schools, but there is not much of a Government imperative to make that happen.
	More joined-up working would be welcome. I hope that in five years' time we shall see more progress.

Kevin Barron: I am sorry that I had to be absent for some of the speech of the hon. Member for Romsey (Sandra Gidley), and also some of the speech of my hon. Friend the Minister. I was asked several weeks ago, as Chairman of the Health Committee, to speak at a reception on the Terrace given by the all-party thrombosis group.
	My hon. Friend said that the official Opposition had a brass neck to table this motion, and I have to agree with her. The motion claims that
	"the gap between the public health of the UK and that of comparable health economies"
	is too wide. Anyone who studied the past 20 or 30 years of public health investment would probably begin to understand why that is so. When in government, the Opposition paid scant regard to the issues that created our present health inequalities and bad health care indexes. They rejected—presumably for ideological reasons—the notion of a direct link between social class and health, placing responsibility entirely on the individual with no reference to housing, environment, occupation or income. I have been in the House for some years—for two decades, in fact—and remember many debates on public health.

Paul Truswell: Does my right hon. Friend remember the Black report on inequalities in health, which is generally regarded as a seminal work on the connection between inequality and ill health? It was smuggled out in photocopied form over a bank holiday weekend by the previous Government.

Kevin Barron: That is right.

Howard Stoate: Will my right hon. Friend give way?

Kevin Barron: I shall give way later.
	The Conservative Government just did not believe what the Black report said—or many other reports by individuals and organisations that had for years been saying why we suffered health inequalities in this country and why public health in some communities was not what it should be.

Andrew Murrison: In similar vein, does the right hon. Gentleman remember the Acheson report that dealt with the same social model of disease, and does he remember the treatment that Labour Ministers gave to that report?

Kevin Barron: I do not remember the detail of that report or exactly when it was published.

Stephen Dorrell: 1988.

Kevin Barron: In that case it was published during the middle of the last Conservative Government's term in office. What should Labour Front-Bench Members have done on that occasion?

Andrew Murrison: I am surprised that the right hon. Gentleman, who is Chairman of the Health Committee, does not know about this, but for his information it was published in 1998, and it was one of the first reports that the Labour party commissioned on coming into office.

Kevin Barron: Yes, I remember that now.
	Let me move on. There has been a conversion in recent weeks and months—it has happened over the past 12 months since the right hon. Member for Witney (Mr. Cameron) took over the leadership of the Conservatives—and it seems remarkable to people who have been involved in the health debate over many years. I am not sure what lessons have been learned.
	The last time I spoke in an Opposition day debate, I discussed issues referred to in the national health service campaign pack that was put out by the Conservative party. It accused the Chancellor of the Exchequer of causing all the problems in the national health service—presumably by almost trebling the budget in the comparatively short time that we have been in office. In that campaign pack, it is also stated that the current NHS funding formula is unfair:
	"Labour have specifically added an element to the allocation formula which aims to tackle health inequalities".
	If the Conservatives do not recognise why the funding formula has to be weighted in some areas in thatway, they do not have, and never have had, any understanding of the causes of ill health in this country. Sadly, communities such as those that I represent have had health inequalities compared with other parts of the country for probably all of the past 60 years when the national health service has been in place and in years before. That has never been tackled, but the Government are now tackling it.
	What have the Government done on smoking since 1997? We have now got a ban on advertising and promotion in the UK, and it has been argued for abroad as well. What happened in 1993-94 when there was a Conservative Government and I introduced a private Member's Bill to ban tobacco advertising and promotion from the Opposition Benches? It was talked out by the Conservatives and not supported by Ministers. Two years later, what happened to warnings on cigarette packets about ill health when the then Member for Worsley, Terry Lewis, introduced a private Member's Bill on that? It was talked out and not supported by Conservative Members who then sat on the Government Benches.
	I could go on about tobacco, but let me ask this: what other Government have matched what this Government have done on tobacco? They have brought smoking cessation targets into communities that suffer ill health because of smoking. That link has been known for decades, yet it has been denied in this House when Members have wanted to introduce legislation to put things right.
	The banning of smoking in public places is also good, although I should say that when the Bill was first published last year my view was that it could have been a bit better—and, indeed, it was a bit better after it had passed through this House and the House of Lords and this House had a vote on it. As a consequence, we are going to bring in the biggest and most comprehensive smoking ban in public places. It is bigger than any of those that have been introduced in the seven states of the United States and than those in Ireland and Scotland, and Wales and Northern Ireland might come in before 1 July next year. It will be probably the biggest public health promotion that any Government have taken on. In campaigning against the smoking industry because of the ill health and deaths that it has caused over the years, I have received very little support from the Conservatives.

Stewart Jackson: rose—

Kevin Barron: However, I am always happy to get converts.

Stewart Jackson: The right hon. Gentleman is making a passionate case for the significant increase in NHS expenditure, but is he happy with the current situation? For example, patients with conditions such as age-related macular degeneration are subject to a postcode lottery. After nearly 10 years of a Labour Government, such patients are literally going blind in one eye before they are even prescribed the drugs that they need to treat their condition. Is the right hon. Gentleman content with that?

Kevin Barron: I have met representatives of the Royal National Institute of the Blind and of one of the drug companies that is introducing a drug for AMD. Such drugs have yet to be licensed and when they are, they will go before the National Institute for Health and Clinical Excellence before they are prescribed—if that is what NICE decides. However, we need to bear in mind certain issues, which I discussed with a health Minister in some detail. I am concerned not about the situation now, but about what might happen when such drugs are licensed. For example, our constituents will be pressing to receive such treatment, but perhaps NICE will take that into account. If the hon. Gentleman is interested in this issue and wants to chat to me about it, I would be more than happy to do so.
	In the Government's amendment to the motion, which I support, they talk about some of the steps that we have taken, such as providing 2 million four-to-six year-olds with fresh fruit at school. I saw for myself last week the trays of apples that a school in my constituency provides for its children. That contrasts greatly with a previous Government, who not that long ago withdrew the provision of milk in primary schools in my constituency. It is true that this Government could do better and could provide more; nevertheless, that contrast is the truth of the matter. As my hon. Friend the Minister said, it was the freshly elected then Conservative Government who, in 1980, reduced the nutritional level of school meals, and I still do not for the life of me understand why. Although this was not true of my family, for many of the families that lived on the estate that I lived on as a child, sadly, the school meal was probably the only hot meal that their children got. That any Government anywhere could reduce the nutritional levels of school meals is farcical.
	On the new healthier standards for school meals, the Opposition have really come into their own. During an earlier intervention, I referred to an incident in September in a neighbouring Rotherham constituency that did not really put Rotherham in a good light. We had the spectacle of two parents pushing a supermarket trolley loaded with burgers, chips and the like through a graveyard and then passing them through the school railings to children who did not like the new school meals introduced by Rotherham metropolitan borough council. The council has been recognised nationally for its healthy school meals initiative, and the vast majority of the schools in my constituency have met all the standards that have been set; in fact, some were meeting them years before they were introduced. I have been interested in this issue for many years, and when I have visited schools during my time as an MP, I have always talked to them about it.
	However, during the week of the Conservative party conference, the Opposition Front-Bench higher education spokesman, the hon. Member for Henley (Mr. Johnson), said:
	"I say let people eat what they like. Why shouldn't they push pies through the railings? I would ban sweets from schools, but this pressure to bring in healthy food is too much."
	This is someone who is supposed to aspire to government—who, as an Opposition Front-Bench education spokesman, is responsible for education matters. I realise that his brief is higher education, which is a slightly different matter; however, how irresponsible can someone in his position get?
	That was a dark time for Rotherham. Anyone who listens to the debate in Rotherham and who reads the letters in the local weekly paper that I am quoting from will realise what the reaction was. There was a heavy reaction against what those parents were doing. However, the result may be that we are having a better debate about food and health.
	Some people think that the hon. Gentleman is something of a hero. One person said:
	"I would welcome him on to the campaign—it would be very useful to have someone high up on our side...I wouldn't know him if I fell over him but I don't understand why he can't say what he likes. Everybody should be allowed to eat what they want without having to be told."
	She capped off her comments by saying:
	"There is all this talk about obesity but there is not one obese child in that school...there are a few chubby ones."
	She went on to say, "I've got a bit of weight myself", or words to that effect.
	If that is seriously the level of response from Opposition Front-Bench Members to the incidents in Rotherham— [ Interruption. ]

Madam Deputy Speaker: Order. May we please have the debate conducted in the usual way?

Kevin Barron: The level of Opposition Front-Bench Members' response to the incidents in Rotherham following the introduction of healthier school meals in September shows that they have a long way to go before they will believe even half of the motion they tabled today.
	Last Friday, I visited the Whiston and Worrygoose junior and infant school in my constituency, because it had just received its second basic skills award for literacy and numeracy. I always make an effort to go to primary schools when such awards are made because, in constituencies such as mine, decades of under-attainment in literacy and numeracy have led to many problems, including ill-health, as has been well recorded by public health professionals.
	The school meals are cooked on site, and I held an impromptu discussion with some year 6 children about the new menu, which I had already had a look at during my visit. The level of their debate was far higher than the hon. Gentleman's comments about what happened at Rawmarsh school. As I said earlier, Opposition Front-Bench Members have a long way to go before they start tabling motions about public health, and especially about obesity.
	In general, public health issues are far more challenging than for the past 150 years. In the past, it was simpler to deal with things that had an impact on public health, such as sanitation, the lack of fresh water, bad housing and dirty air, before the clean air legislation of the 1950s. All those things had a bad effect on public health but they were reasonably easy to tackle—be it by central Government or, in most cases, by local government. Of course, that is not to say that there is no bad housing or that housing could not be better, but its public health effects are not as great as they were in years gone by.
	The issues that will lead to public health problems in the 21st century are affected by the individual decisions we take each day, in terms of our lifestyles and of what we eat and drink. The Government have to tackle those things. In part, that can be done by education. Educational campaigns are a cheap and effective way of raising awareness of health problems, but evidence suggests that awareness does not always translate into changed behaviour. Adolescents do not necessarily smoke or drink less as a result of health education programmes. I have campaigned against smoking for many years and I have always felt that we will never completely stop young children trying cigarettes. There will be some success but it will never be total while cigarettes exist. The important thing is to continue those education programmes.
	Another area where there can be success, and has been success in the past, is taxation. One thing to the credit of the Opposition is that, when they were in office, the then Chancellor of the Exchequer, the right hon. and learned Member for Rushcliffe (Mr. Clarke), put a health tax—an above-inflation tax—on cigarettes. The figures show that that reduced consumption. When the Conservatives went into opposition, he got a job as vice-president of British American Tobacco. I do not know whether that was cause and effect, but the people there were not very happy with him at the time. Taxes on alcohol also reduce consumption. That does not mean to say that people will stop drinking or smoking, but there is an effect.
	One thing that we could do, and that has been effective in the past, is to bring in restrictive measures, such as the banning of tobacco advertising. Some of the big public safety areas—outside this area—include things such as seat belts in cars. I remember them being put in when I was first driving, when it was not compulsory to wear them. It was only when legislation was passed that take-up levels of people wearing seat belts became as high as they are today. The same could be said in relation to drinking and driving. When measurement was brought in and we said, "This is an offence. You will lose your licence," things quickly got a lot better.
	I want to finish with two points about where we should go in the future. As I said, I do not think that all these things are a matter for the state. I certainly do not think that they are necessarily a matter for the national health service. There is a lot evidence that other organisations—I think that the Government call them non-governmental organisations or the third sector—can have great influence in relation to what is happening in our health care system or, perhaps I should say, individual needs.
	A note was passed around earlier about weight loss programmes in South Cambridgeshire. I have with me the outcome of research that was done on a slimming referral service in Derbyshire. The report is from the journal of the Royal Institute of Public Health. It was a collaboration between the Southern Derbyshire health authority as it was then, and Slimming World, which is a high street company that helps people to lose weight. I know that Weight Watchers does that too, so I am not advertising one against the other. The referrals are beginning to work. There is no question about that, looking at the report that I have here. It provides evidence that, sometimes, these types of referral schemes are better than going to see a dietician locally and being told to go away and lose weight, and getting advice such as, "Don't eat this. Don't eat that." Instead, people sit in the village hall with somebody who has been through the process, who usually leads the class, and can tell people about how easy it has been.
	One of the things that struck me about this scheme is that, of the 107 patients who were originally referred, 97 enrolled, 62 completed the free 12-week course and 47 went on to self-fund the next 12-week course and did it themselves, and stayed with that weight-referral programme. There are experts out there—not necessarily working for the national health service, but working close by—who can help in many ways with individuals who have weight-loss issues, which, if not tackled, will certainly lead to disease and, potentially, an early death in years to come.
	GlaxoSmithKline nutritional health care had a study done about how to get families involves in physical exercise, as well. We had a debate about rugby or football at school. Well, all that stops at 16 anyway, but what about the vast majority of kids, who are not much good at rugby or football at school? We always think that exercise is about people who are involved in one sport or another, but exercise could be going to school or work on a bicycle. It could be many things. We need to learn where there is evidence—not just in the national health service; in wider organisations—and make sure that that evidence base is the real area where we start decision making. The national health service should have been taking evidence-based decisions for the past 60 years, but, sadly, its track record on that has not been good. It is about time that we got better, especially in areas in which individual lifestyles will have an impact on public health in the years to come.

Stephen Dorrell: I intend to be reasonably brief. I congratulate my Front-Bench colleagues on focusing the House's attention on public health as the core of this country's health policy. When we discuss the national health service and health policy, we focus too often on the machinery of health delivery, rather than the objective of delivering public health standards. The House of Commons is today holding the Government to account on the delivery of health outcomes using the national health service and all other instruments of public policy at their disposal, which is what they should be accountable for.
	As my hon. Friend the Member for South Cambridgeshire (Mr. Lansley) said, the fact of the matter is that there have been disappointing trends in a wide range of health outcome measures, such as alcohol and drug-related disease, the incidence of tuberculosis and sexual health. Those three measures have already been mentioned, but one could continue to list other measures of health outcome on which the value that the taxpayer—and the patient, more importantly—has received from the money spent on the national health service has been disappointing throughout the past decade.
	The hon. Member for Sherwood (Paddy Tipping), who is no longer in the Chamber, latched on to part of the speech made by my hon. Friend the Member for South Cambridgeshire and said, "Oh, now what you're interested in is targets." However, targets for health outcomes are precisely what the Government should be setting, before holding themselves to account on the delivery of those targets. We were the first Government in office to do precisely that. The White Paper "The Health of the Nation", which, I think, was published in 1991, set health outcome measures that defined the objectives for the delivery of health policy. The disappointing aspect of the past few years is that we have not used taxpayer pounds effectively enough to deliver those health outcome objectives.
	My hon. Friend could have gone on to talk about not only average health outcomes, but differential outcomes in various parts of the country and health inequalities. It is often said—it has been said again today—that the Conservative party has somehow denied the existence of health inequalities or the link between social class and health inequality, but that is simply not true. It is one of those oft-repeated assertions that does not reflect reality. Of course it is true that social background and a wide range of other issues influence health outcomes and form someof the background to health inequalities. One of the criticisms of the Government is that their management of the health service has been insufficiently focused on using taxpayer pounds to address precisely the reasons why the national health service was established: to narrow health inequalities and to even up the experience of health treatment in different parts of the country.
	It is not difficult to find out why the Government's record on delivering those objectives has been disappointing. Indeed, one does not need to look further than the July 2006 report of the chief medical officer to read many of the causes of that disappointing record. The situation is easily summarised. A vicious circle has been allowed to generate over the past decade, and weak public health discipline in health service management has led to weak commissioning. Indeed, for part of the Government's period in office, they were not even interested in the principle of commissioning. I am pleased that they now recognise the importance of commissioning in the management of the health service, but they are disabled from delivering strong, effective, evidence-based commissioning because of their long period of disinterest in both commissioning and the development of the public health discipline as the key evidence base for strong commissioning. Weak commissioning has led to misdirected spending in the NHS, which has led to poor outcomes when measured against health outcome objectives.
	That has resulted in what taxpayers overwhelmingly now recognise in the record of the present Government. A huge sum of money has been spent on health care in our country—a sum of money that, I am pleased to say, the Conservative party strongly supports. Government Members like to assert not only that the Conservatives are blind to health inequalities, but that we oppose the Government's health spending programmes. Neither assertion is true. What we oppose is unloading such a sum of money on the health service at the same time as weakening its management and thereby undermining its capacity to deliver good value for money.
	Over the past decade, the national health service has failed to target resources on the real health priorities, partly because, in his time as Secretary of State for Health, the right hon. Member for Holborn andSt. Pancras (Frank Dobson) set out to abolish and destroy the structures that allow NHS management to target resources at genuine health need. Now, those structures have been reintroduced and the Government are struggling to make up the ground that they lost in their early period in office.
	The House does not have to take my word for that, or the word of my hon. Friend the Member for South Cambridgeshire. As I have already said, the position is set out clearly in the report of the chief medical officer, published in July. He says:
	"public health departments have been caught up in a great deal of reorganisation,"
	and he makes it clear that that reorganisation has weakened the capacity of public health managers to direct resources at need. He continues:
	"Public health budgets are regularly 'raided' to find funding to reduce hospital financial deficits".
	It is a classic case of the urgent squeezing out the important.
	More positively, the chief medical officer recommends a series of actions. There is no point in well paid and, more importantly, authoritative public servants issuing statements recommending action to Ministers, who should heed those recommendations, if Ministers let the reports simply gather dust on the shelf.

Kevin Barron: Did the right hon. Gentleman take all the action that the CMO recommended he should take when he was Secretary of State for Health?

Stephen Dorrell: I doubt that I did everything that the chief medical officer recommended that I should do, but I would never have objected to anyone pointing out to me what the CMO had recommended and asking me why we were not doing it. My challenge to Ministers takes the form of the three recommendations in relation to the public health discipline that the CMO made, publicly, in July.
	The first recommendation is:
	"Consideration should be given to establishing a comprehensive review (the first in almost 20 years) into arrangements to improve and safeguard the health of the public."
	Earlier in the debate, a misunderstanding arose between my hon. Friend the Member for South Cambridgeshire and me. The last review of the public health discipline in this country was carried out by Donald Acheson, who published his report in 1988—almost 20 years ago. The present chief medical officer recommends, and I agree, that it is high time that that work was reviewed, not least because Donald Acheson recommended a level of commitment to the public health discipline by 1998 that in 2006 is still not matched. I hope that Ministers will tell the House when they intend to honour that first recommendation.
	The CMO's second recommendation is that
	"Health service commissioners should take steps to satisfy themselves that expenditure on public health reflects the needs of their population."
	I believe that Ministers accept that now. It is a pity that during the 10 years in which the Labour Government have been in office, they have not focused resourceson need through commissioning —[ Interruption. ] The Minister says that they have, but her predecessors in the period in which the right hon. Member for Holborn and St. Pancras was Secretary of State for Health did not believe in commissioning and made it clear that he intended to wind it up, so it is hard for her to make that claim for the whole 10 years in which Labour has been in office.
	The third recommendation is that all NHS bodies should ensure that their public health capacity and capability are sufficient for their proper functioning. In his report the CMO makes it pretty clear that he does not believe that the present level of public health commitment is fit for purpose. Furthermore, he draws attention in his report to the fact that there is a twentyfold variation—this is a health inequality among the different parts of the country—in different PCT areas in their commitment to the public health discipline. That cannot be the record of a Government who accept the importance of public health as the backbone to well informed commissioning.
	I conclude with the simple thought with which the chief medical officer heads the chapter on the subject in his report—"Raiding public health budgets can kill". It is like the advertisement on cigarette packets. Raiding public health budgets can kill: that is what the Government are doing, and that is the consequence for which they must accept responsibility.

Howard Stoate: I am delighted to take part in the debate as I am co-chair of the all-party group on primary care and public health, and as the House knows, I still do some work as a practising general practitioner.
	I am particularly pleased that the Government have set 1 July as the date for the implementation of smoke-free legislation in England. I hope that the Minister will follow that up with the announcement of a major public education campaign to ensure that the public and licensees are fully aware of the implications of the new legislation.
	Next year's date will also provide a major incentive for smokers to quit. As well we know, of the 12 million smokers in this country, at least 8 million at any one time would love to give up smoking. I hope that they now have a date to work to, so that they can plan their strategy. I am pleased that in general practice we can prescribe nicotine replacement therapy and that most practices, if not all, have nurses who are well trained in helping people to stop smoking. Coupled with the prescriptions that we are able to give on the NHS thanks to the Government, that is making an impact on the number of smokers whom we see. That will reduce the burden of ill health in the future to a welcome degree.
	In line with the polluter pays principle, I would like to see a profits tax on tobacco companies thatwould fund educational programmes on the health risks of passive smoking and the monitoring and implementation of smoke-free public places. I know that that is controversial, but it would show that the Government meant business by making sure that the companies that profit from smoking put something back into the community to educate people on the ill health which that causes.
	I also support proposals to raise the minimum legal age for the purchase and sale of tobacco from 16 to 18. Far more needs to be done to discourage children from smoking, and increasing the limit to 18 would be a step in the right direction. Raising the legal age would also send a strong clear message to young people about the dangers of tobacco, and in conjunction with other anti-smoking strategies would, I hope, help teenagers resist taking up a habit that many of them will live to regret in their shortened lives.
	It has been stated that alcohol is implicated in about 40,000 deaths per year in this country and is directly responsible for 5,000 deaths a year. That is a jumbo jet full every month. The World Health Organisation recently identified alcohol as the third highest risk to health in developed countries. Almost 40 per cent. of men and 25 per cent. of women exceed daily benchmarks of three to four units for men and two to three units for women on at least one occasion a week. Twenty per cent. of men and 10 per cent. of women drink more than double the daily limit in one session at least once a week.
	The rate of binge drinking is even more alarming among young adults: 37 per cent. of 16 to 24-year-old men and 27 per cent. of 16 to 24-year-old women binge drink regularly. Between 1988 and 2000 the number of women consuming over 14 units a week rose by 70 per cent. Approximately one in four 16 and 17-year-olds are hazardous drinkers—that is, they have experienced immediate problems, such as loss of memory, injuries or failure to do what is expected of them, after a night's drinking. Among 16 to 24-year-olds, this figure rises to 42 per cent.
	Even more alarmingly, 11 to 15-year-olds who drink alcohol now consume nearly twice as much as they did in 1990. They consume on average 9.8 units a week, compared with 5.3 units a week in 1990. Since the early 1970s there has been an eightfold increase in deaths from chronic liver disease among men aged 35 to 44, and a sevenfold increase among women of the same age group.
	It has been estimated that alcohol costs the NHS up to £3 billion a year in hospital services alone. Every Friday and Saturday night, 70 per cent. of all accident and emergency admissions and 80 per cent. of pedestrian road deaths are alcohol related. One in four acute male admissions is alcohol related. The cost of alcohol abuse to the wider economy is estimated at£20 billion a year.
	There are two key factors in the increase in heavy drinking, particularly among young adults—price and availability. Alcohol is getting cheaper. In the past40 years, consumption per person has doubled and the price of alcohol relative to income has halved. The number of shops selling alcohol has risen sharply, and a third of all 24-hour licences granted were given to supermarkets, where alcohol is cheapest.
	I do not want to be a killjoy at Christmas, but the fact is that alcohol will wreck many lives over the festive period, and we need to take firm action. I propose that the Government should move towards legislation on banning the advertising of alcohol as they have for cigarettes. We need to emphasise the impact of alcohol abuse in young people on the development of drug habits and to improve recognition of the need for counselling and treatment services, particularly for young people. There is also an urgent need for more school-based education founded on an understanding of young people's perceptions of drinking.
	There are about 1 million obese children under the age of 16 in the UK—three times as many as 20 years ago. Those soaring obesity rates have led to an increase in childhood type 2 diabetes, which will lead in future to more heart disease, osteoarthritis and certain cancers. Estimates indicate that if current trends continue, at least one fifth of boys and one third of girls will be obese by 2020. I am pleased that Ofcom has finally put forward proposals to restrict the number of advertisements for foods high in fat, salt and sugar, but they do not go far enough.

David Taylor: If my hon. Friend were public health Minister in a future Administration, would he follow the example of Canada, which has banned the use of trans fats in processed foods? Trans fats have double the damaging effect of saturated fats and are a serious health risk that has loomed large over the horizon. Does he agree that that issue must rise up our own Government's agenda?

Howard Stoate: I thank my hon. Friend for an interesting observation. As he says, trans fats have been implicated in significant levels of disease. I am pleased that Canada, among other countries, has outlawed them completely, and I would like this country to move towards doing so. There is no technical reason why the food industry cannot use the available alternatives—it is just a matter of the will to do so. I hope that the Government will be able to push food manufacturers in the right direction on that important issue.
	We need to go further on banning advertising of foods high in fat, salt and sugar, mainly because the fact that Ofcom's proposals will not affect some of the programmes popular among children, such as soaps and quiz shows, will significantly undermine the impact of the ban. It would be far more effective and meaningful if the cut-off point were extended to the9 o'clock watershed, which all parents understand.
	There is very little evidence about the effectiveness of intervention. More research is needed on the effectiveness of weight management and treatment programmes, the longitudinal impact of obesity on individuals and society, and the impact of physical activity on obesity and co-morbidities.

John Pugh: Two aspects contribute to obesity—lack of activity and taking in the right foods. How would the hon. Gentleman weigh those factors in terms of reducing obesity?

Howard Stoate: The hon. Gentleman makes an important point. Obviously, the food manufacturers would say that it is all about activity, while other specialists, particularly those from the National Obesity Forum, say that it is a much more complex interaction between calories in and calories out. Nothing like enough is known about the relative merits of calories and activity. There is clearly a relationship between the two, but it is necessary to do far more work to find out exactly where the problem lies so that we can come up with more effective strategies.
	One of the most worrying aspects is that many parents do not have enough information to make healthy choices for their children. A MORI poll carried out some years ago found that 70 per cent. of parents said that they did not have the information that they needed to ensure that their children ate a well-balanced and healthy diet and that much more needed to be done. We need a much more sustained and consistent public health campaign to improve parents' and children's understanding of the impact and benefits of healthy living. Families need to be educated and empowered through guidance that recognises the impact of those factors on children's development of lifelong habits to do with eating and activity.
	There is a strong case to be made for the establishment of a national obesity institute to improve collaboration between stakeholder groups. In addition, extra funding should be available to establish and sustain training programmes for those involved in the care of children with obesity. That should be complemented with resources to allow children to gain access to specialist regional obesity services. We simply need more specialist nurses and GPs. Every primary and secondary school should have a school nurse to advise children on healthy living and other lifestyle issues. At present, there is only one school nurse for every 10 or 11 schools in the country, and we should improve on that significantly.
	There should be increased access to subsidised sporting facilities for children and their parents. Ready access to such facilities is particularly important for those from lower socio-economic groups. "Exercise on prescription", provided at reduced cost, or free of charge, should be expanded. I was pleased to hear the Minister's recent announcement about prescribing more exercise classes; that is a welcome step in the right direction.
	We have heard a fair amount about sexually transmitted infections this afternoon. The latest report from the Health Protection Agency presents data for 2005. Through the presentation and description of epidemiological data, the report highlights the fact that, despite the increasing complexity of the situation, our HIV and sexually transmitted infection surveillance systems have evolved to become among the most comprehensive and informative in the world, and that is very welcome. It is essential to campaign for education strategies that increase young people's knowledge of the full spectrum of sexually transmitted infections.
	Well-designed sex education programmes have been shown to be effective. The Men's Health Forum recently carried out a project, aimed to reach men with messages about chlamydia and sexual health, and it was a good example of an effective education programme. The project was backed by the Department of Health and Roche Diagnostics, and it worked with male students and soldiers to increase understanding of young men's attitudes to sexual health. It was followed by a programme in which testing kits for chlamydia were made available for collection from men's toilets, including some in university colleges. Positive health behaviours must be promoted among individuals who are infected, so that they come forward to seek treatment and go on to practice safer sex. We must ensure that we go ahead with improving access to GUM—genito-urinary medicine—clinics. I am pleased that my hon. Friend the Minister announced an aim of reaching the 48-hour target by 2008; that is very welcome.
	We have already heard about the importance of maintaining a specialist public health work force. The recent reconfiguration of strategic health authorities and primary care trusts has so far led to a reduction in the number of directors of public health from 303 to 152. I hope that all the people displaced by the reorganisation will be re-employed as public health consultants, because we must make sure that we do nothing to undermine or reduce the important work done by directors of public health and their departments.
	I hope that, in partnership with local authorities and voluntary organisations, directors of public health and public health consultants will continue to ensure that the local population's needs are assessed and addressed through public health programmes. They currently provide leadership in three domains of public health: health protection, health improvement and tackling health inequalities. I am concerned to make sure that the reconfiguration of PCTs and strategic health authorities in no way reduces or dilutes the work that is currently carried out.
	For us Labour Members, the story has been one of good news: the reduction in mortality rates for heart disease, strokes and cancer are impressive, and, as we heard, there has been a significant extension of the childhood immunisation programme, which has certainly prevented many hundreds, if not thousands, of preventable deaths among young children. We have every right to be very proud of our record, but the old adage is true—a lot has been done, but there remains much to do. I am keen to work with my colleagues on the Front Bench to make sure that the improvements made in recent years on public health are maintained.

Nadine Dorries: I shall focus on sexual health, but first I should like to pick up the Minister on a comment that she made about flu vaccines. She said that she "allowed" an increase in flu vaccine provision this year, but may I remind her that the only allowing that takes place is on the part of the British public, who allow us to come to the House to serve them? Her comment may be indicative of the extent to which the Government are out of touch with the British people; we do not "allow" the British public anything.
	An entire generation has been let down and blighted by the Government's failure to protect our teenagers in respect of sexual health. The Government knew that there was a problem with sexual health, and that is why the Secretary of State announced that £50 million was to be spent on a sexual health campaign, but only£4 million was spent. We can see a pattern emerge: when any investment is made, or when the Government want to take credit for any inward investment, they do so, but the minute that there is a problem, they blame the hospital managers. However, hospital managers cannot be blamed for the statistics. In 2004-05, cases of syphilis were up 23 per cent., chlamydia was up 5 per cent., genital warts was up 1 per cent., and genital herpes was up 4 per cent. Newly diagnosed cases of HIV doubled in 10 years and, among women, there was a sixfold increase in 10 years, with 3,036 cases now being diagnosed a year. That cannot be blamed on hospital managers.
	Despite those figures, hospitals are deciding to cut their genito-urinary medicine departments completely. A local newspaper ran a story about my local hospital, Bedford hospital, saying:
	"The next round of cuts at Bedford Hospital will be unveiled today, with sexual health the main casualty...The document proposes that Genito Urinary Medicine..is moved out of the hospital, to be dealt with by GPs".
	I had a quick ring-around of my local GPs, who said that they have no specialist training in genito-urinary medicine, and have absolutely no idea how they are supposed to cope with genito-urinary medical problems in their surgeries, given the increase in sexual health problems.
	Some people criticised the AIDS campaign of the 1980s, which was mentioned earlier, because of the tombstones and the eerie images, but at least it gotthe message home. It meant that the general public knew how important safe sex was and what the consequences of not having safe sex could be. It is hardly surprising that new cases of HIV have risen dramatically. According to the Department of Health's own statistics, two thirds of men and women newly diagnosed with HIV said that they received no written or televised information, and that no information that they received had affected their sexual health. The same set of statistics, revealed by the Government, show that most people learn about HIV and AIDS through television soaps, so people learn more about AIDS from EastEnders than from the Government.
	Recently, the Minister decided that there should be a supermarket-wide poster campaign teaching children how to eat bananas.

Caroline Flint: No, I did not.

Nadine Dorries: Well, I have obviously got it wrong, then, but that is what was announced.

Caroline Flint: I thank the hon. Lady for giving way, because it gives me the opportunity to put the matter straight. It is not the case that I was encouraging a campaign with that aim. I went to an event organised by Sainsbury's that involved parents, who said that, if they were to try more fruits and vegetables—not bananas and apples, but other, perhaps less common, fruits and vegetables—it would be great if the supermarkets allowed tastings in their stores. Parents, particularly those on low incomes, felt that they might then spend their money on trying a variety of fruit and vegetables. That is about listening to parents on how they think that the industry, and supermarkets, could help.

Nadine Dorries: I can only suggest that the Minister take the matter up with the BBC, which widely reported that there would be a supermarket-wide campaign, teaching children how to eat bananas. Those are the exact words taken from the BBC website. In an age of over-sexualisation of children, where teenagers are constantly under pressure from television, magazines, cinema, peer-group behaviour and retailers, does the Minister not think that it would be more important to send out clear messages on sexual behaviour and personal values, and does she not think that we should spend some of the £50 million that was promised on hard-hitting advertising campaigns?
	Research suggests a strong link between social and economic disadvantage and early initiation into sexual activity. That wealth distinction is also evident in the number of teenage pregnancies and teenage mothers. Teenage girls from poorer backgrounds are four times more likely to give birth than those from affluent backgrounds. We have the highest rate of teenage pregnancy in Europe and one of the highest abortion rates. What kind of testament is that to a society, and what are the Government doing about the issue? I am sure that all hon. Members have heard of the morning-after pill, which works before the ovum attaches itself to the wall of the uterus. It works better the earlier it is taken. If someone wants to get hold of it, they can ring their GP. The highest users of the morning-after pill belong to the ABC1 group. They may ring up their GP practice to make an appointment, only to be told that one is not available for five days. However, they will insist that they see a doctor or, alternatively, they can go to the pharmacist and pay £25 for the morning-after pill, because they can afford to pay it.  [ Interruption. ] Hon. Members may wish to know that the morning-after pill is free from a GP practice, but it costs £25 at the pharmacy.

Sandra Gidley: Is the hon. Lady not aware thatin many areas, under a patient group directionthe EHC—emergency hormonal contraception—is available free of charge at pharmacies that adhere to certain protocols?

Nadine Dorries: In fact, it is not available in many areas. It should be available in all areas, so that other groups can gain access to it. It is another case of the postcode lottery. In certain parts of the country, women have to pay £26 for the morning-after pill atthe pharmacy, which is open all hours, including Saturdays—anyone can walk into one—but that is not the case in other parts of the country. It is free in only a small number of areas, but to reduce the number of abortions in the UK—there are 600 a day—we should make it free at all pharmacists. After all, it is provided free by GPs.

Diana Johnson: Does the hon. Lady agree that women should have the right to request abortion in the first 12 weeks of pregnancy without needing to secure a doctor's approval?

Nadine Dorries: I do not have any thoughts one way or the other on abortion in the first 12 weeks, but I believe that the limit for abortions should be reduced from24 weeks to 21 weeks, as I have argued previously in the House.
	The Minister should keep her eye on the ball, and spend some of that £50 million on sexual health campaigns, as poor sexual health has blighted the lives of many teenagers. I urge her to make the morning-after pill free on demand at pharmacists, particularly in areas with the highest numbers of teenage pregnancies. I urge her to look at research that shows that women who have abortions suffer mental health problems later in life as a consequence, and to provide public health information to parents. She is throwing money at British pregnancy advisory service clinics, but will she look at more effective ways of reducing the number of abortions, instead of continuing to fund a growing industry with NHS money?

Natascha Engel: I am grateful for the opportunity to follow the hon. Member for Mid-Bedfordshire (Mrs. Dorries), as I should like to pick up some of the issues that she raised. I thank the Opposition for again offering the House a chance to debate a hard-core Labour issue. Time and again, the Tories choose to debate the policies on which we are strongest, pursuing hollow lines of attack without presenting clear policies or alternatives that we can debate. In their constant to-ing and fro-ing, defence appears to be the best form of attack. They have been at it for several hours without providing any proper debate, which is rather tiring. However, I thank them for raising the issue of public health in the House.
	Public health, as I said, is one of Labour's great success stories. As the Opposition said, for the first time we have a Minister with specific responsibilities for public health, who liaises closely—this is a key point—with officials in the Department as well as with welfare officials, with the Treasury on matters such as income equality, with education officials and, most importantly, with the social exclusion unit. Our strongest achievement in public health is the social exclusion agenda. We introduced the national minimum wage and tax credits, both of which have helped to tackle low income—a major factor in poor public health. We introduced welfare reforms—along with some Opposition Members who have participated in today's debate, I served on the Committee that considered the Welfare Reform Bill—that command widespread consensus.
	Public health is the key to delivering the welfare reform agenda. For example, encouraging people into work helps them to achieve better health. Today's debate, however, has had a narrow focus. We have looked at teenage pregnancy—an important issue, I accept—but it would be nice to broaden the debate. Since we have been in government, we have delivered phenomenal achievements in education. We have never seen anything like Sure Start and children's centres, which have revolutionised the way in which we deliver public health, enabling us to engage with young parents, including teenage mothers, in a radically different way. I have made any number of visits to Sure Start projects and children's centres in deprived communities in my constituency. I have seen children eating fruits that I have never seen before, and they were enjoying the experience. Recently, I visited a children's centre in the most deprived ward in my constituency. The vast majority of kids were from Traveller families, and a third of the children at the centre had special needs. Staff engaged not just with the children but with their parents, bringing them into contact with education, to which they have not had access before. That is public health, and we have delivered it.
	Sexual health is an important issue, but it is difficult to discuss, both inside and outside the House. Parents, for example, are uneasy talking about sex education, sexually transmitted infections and contraception. We need to be more adult in our approach, and we must continue to raise the issue without embarrassment. The Labour proposal to employ nurses in schools is quite brilliant, as it would go a long way towards removing the embarrassment factor in sex education. I would argue, however, that the introduction of sex education at secondary-school level is too late. It should be offered in primary schools, and we should introduce legislation to that effect. It is fantastic that 80 per cent. of schools have taken part in the health schools campaign. It proves that if the will is there we can introduce change, so we should provide sex education in primary schools.
	We need to tackle sexually transmitted infections more effectively. It is important to make contraception far more readily available, but the Department of Health has ring-fenced £300 million—that figure is separate from the £4 million for national campaigns on sexual health—for primary care trust budgets. Some PCTs—not my own, I hasten to add—have used that money to pay off deficits, which is wrong. We must make sure that others do not do so, but it is important to accept that that £300 million has been ring-fenced.

Nadine Dorries: If that is the case, why did Lord Warner say that most of the money was still sitting in NHS coffers?

Natascha Engel: The Opposition cannot have it both ways. If they wish to argue that PCTs are spending that money on their deficits, it cannot be sitting in Department of Health coffers. That £300 million is targeted at sexual health services, which the Government have listed as one of their top six priorities, so it will make a fantastic contribution.

Nadine Dorries: Lord Warner said:
	"My Lords, it is stored carefully in the coffers of the NHS. As the noble Earl is aware, the NHS is a very cost-conscious organisation, which tries to ensure that it uses its money wisely...we have to evaluate each of these campaigns to see how effective they are and then consider the next steps."—[ Official Report, House of Lords, 21 November 2006; Vol. 687, c. 231.]
	Steps to allocate the money, however, have not been taken.

Natascha Engel: I shall not even bother to answer that.
	I would like to pick up one of the points that the hon. Member for Mid-Bedfordshire made earlier about sexual health services being taken out of acute units into general practice surgeries. That is a key element of what we are trying to do—to localise, to make more familiar and to make it easier for young men and women to access those services. I do not know how many gynaecological units the hon. Lady has visitedin her own constituency or elsewhere, but those environments are not as friendly as general practices.

Anne Main: May I say that our genito-urinary medicine unit consultant, Dr. Pat Munday, resigned because she was short-staffed after posts were frozen? She operates a drop-in unit. She says that people do not always want to go to their GP, as they want the facility of sexual health units, so it is no good just saying that everything can be moved back into GP surgeries.

Natascha Engel: Obviously, diversity of choice is an issue and people should be able to go wherever they feel most comfortable. We also need to recognise that confidentiality is a big issue. These services shouldbe available at GP clinics, at polyclinics, which are absolutely key in this sphere, and at acute units. The real issue is that we need to ensure that those services are available and can be accessed, especially by young men and women, so that we tackle sexually transmitted infections. I end there.

Several hon. Members: rose—

Mr. Deputy Speaker: Order. It is anticipated that the winding-up speeches will start at about half-past six, and four hon. Members are seeking to catch my eye, so the arithmetic is self-explanatory. I hope that Members will bear that in mind as they make their contributions.

Jeremy Hunt: First, it is a pleasure to follow the hon. Member for Dartford (Dr. Stoate) in this debate, as both he and I have put some of the issues that we have talked about into practice. We both entered a competition for MPs' fitness with  Men's Fitness magazine. I pay tribute to the hon. Gentleman for winning the competition, but I warn him that I came top on the running machine, so I hope that he has the stamina to listen to what I have to say.
	It is also a pleasure to follow the hon. Memberfor North-East Derbyshire (Natascha Engel) and I want to answer her central question. She asked whythe Opposition have brought about today's debate. The reason is very simple: a central plank in the Government's public health policy—addressing health inequalities—has been a failure.
	There has been much discussion this afternoon about the distant past, but in the near past—the last nine years—life expectancy has still been seven to eight years lower in the poorest parts of the country and the inequality has widened by two years for men and five years for women. The crucial reason is not a lack of good intentions, but a lack of understanding that investment in public health—not in clinical services, however critical—is most important for successfully addressing health inequalities.
	The chief medical officer's annual report on public health spelled that out very clearly. He said that investment in public health was falling as a proportion of expenditure in the NHS, that the number of public health professionals was static and that public health budgets had been raided and used to fund deficits. We heard a raft of statistics showing why the Government's policy is failing. Alcohol-related deaths are up; tuberculosis infections are up; syphilis up; chlamydia up; obesity rising; and smoking declining, but inequalities persist among smokers.
	The failure to understand the difference between morbidity and mortality is critical because, in the end, the incidence of poor public health has to be matched with investment in public health and the incidence of disease has to be matched with investment in clinical services. The result of that misunderstanding is a grossly unfair funding formula.
	I would like to tell the House about my own area of Guildford and Waverley. The hospital and community health services budget for 2007-08 is increased by 2 per cent. because there are many older people, but it is reduced by 25 per cent. because of a lack of deprivation. What is the impact? Last year, my constituents had to wait twice as long as people in Manchester for ear, nose and throat elective surgery. They had to wait nearly twice as long for breast surgery compared with people in the Health Secretary's Leicester constituency; and three times as long for trauma and orthopaedic work as people living in the Prime Minister's Sedgefield constituency.
	This year, as a result of problems in the funding formula, my constituents face the closure of Milford hospital, a community rehabilitation hospital, and of the Royal Surrey County hospital—one of the top accident and emergency hospitals in the country, which happens to have the joint lowest mortality rate, as well as being a foremost cancer specialist centre.
	I want to brief, so I shall make just one final point. Another vital factor for public health is stability in budgets, but in my area of Guildford and Waverley, there was a budget increase of £9 million last year, while this year it has been told to reduce spending by £16 million. There is a phrase for that—boom and bust. If we are to change people's attitudes—we have talked about the importance of doing that this afternoon—it requires sustained investment over a period of time, not boom and bust.
	Today, the Prime Minister is reported to be telling the NHS Confederation that service improvements in NHS hospitals are being implemented to ensure that the very sick have speedy access to specialist care, but also to treat people more conveniently closer to home.

Anne Main: On that very point of access to specialist care and specialist nurses, two out of four specialist breast cancer nursing posts have been frozen in my hospital owing to cuts and deficits, yet there has been a target that all those diagnosed with breast cancer should have access to specialist nursing—a targetmet only in 74 per cent. of cases in my area.By withdrawing funding and making cuts, the Government are penalising specialist nurses.

Jeremy Hunt: From what my hon. Friend says, it is clear that my constituency is not the only area suffering from boom and bust.
	I return to what the Prime Minister is saying. He talks about all these so-called improvements, but which part of the country is he talking about? In my part of the country, he is closing our local hospitals, closing our accident and emergency services and health inequalities are rising. Inequality in access to health care is rising and the Prime Minister has delivered a boom that has become a bust. People are saying that enough is enough.

John Mann: I have a few questions for the Minister. The healthy living project in my constituency has the ambitious vision of becoming a centre for sport and learning with a GP practice, community nurses and youth workers built into it. Will the Minister take a particular look into that idea, not least because the aim is to build health facilities on a school campus in order to create a new concept of an extended school?
	Secondly, will the Minister look into the "Do it4 Real" project run by the Youth Hostel Association, which the Minister with responsibility for youth is currently considering refunding? It is important to see how children from disadvantaged communities are being engaged in a summer school for all kinds of backgrounds and communities—with healthy and active living as a theme. Will he reflect on the uniqueness of that external organisation and how it has helped to provide opportunities for the development of basic cooking skills for today's microwave generation? Could that particular programme be taken to another level—perhaps with slightly older children—and develop some key skills that children will require for healthy living as they get older?
	Thirdly, will the Minister look into the possibility of conducting a longitudinal study, comparing three-to-18 schools with schools to which children change at age 11, to assess whether the engagement of young people is any different in the different types of school, particularly in respect of their involvement in healthy lifestyles? That involves both the food that children eat at school and their active participation.
	My fourth question is aimed more at the Opposition and I am sure that Conservative Front Benchers will want to illuminate an issue that has remained unclear for some time. Will the hon. Member for Westbury(Dr. Murrison) clarify his party's precise drugs policy on heroin injecting rooms, which have been supported on a number of occasions by his party leader? How precisely will they fit into a public health agenda, should the Conservative party ever be returned to power?
	Conservative party policy at the previous election was to provide rehabilitation places for 18,000 under-18s. However, it has not yet explained its policy on the 200,000 adults who have an addictive drug problem. Where will they be treated?
	The motion refers to "comparable health economies". On drugs policy, it would be helpful to know which country, in the opinion of Opposition Members, mirrors Conservative party policies on drugs most closely.

Peter Bone: It is a great pleasure to follow the hon. Member for Bassetlaw (John Mann), who made his points succinctly.
	The amendment claims that the Government are tackling inequalities. In their 10th year in power, they have failed miserably and completely to do that, especially in north Northamptonshire. It was right for Her Majesty's Opposition to use the Opposition day to highlight the Government's failure to reduce health inequalities.
	Let me begin by setting out the founding principle of the national health service. It is that everyone should have access to similar health provision wherever they live in the country.  [Interruption.] That was greeted with derision by Government Front Benchers. It is unfortunate that they do not believe in the founding principle of the NHS. That principle is that all people should be treated fairly. However, in my area it is not upheld. Under the Government, my constituents do not benefit from a national health service, but are instead victims of a postcode lottery health service.
	In my constituency, I run the Listening to Wellingborough and Rushden campaign. I formed it several years ago and its purpose is to listen to the views and opinions of local people and campaign on their behalf. One cannot campaign about people's concerns without first finding out what they are. My listening campaign continually strives to ascertain local opinion through surveys, leaflets, meetings and events. One issue that consistently shows up in my Listening to Wellingborough and Rushden survey as either the biggest or the second biggest concern is health care and the lack of local provision. I pay tribute to the excellent work of the doctors, nurses, support staff and medical professionals who work in my area. I am also grateful to the staff who run the two hospitals that my constituents use—Kettering hospital and Northampton general hospital—and those who run my local primary care trust. They daily struggle to provide top quality patient care while having to keep Government accountants satisfied. That is not an easy job and I thank them for their hard work in challenging times.
	There is a major problem with health care provision in my area. I have raised it in this place previously and I will continue to do so until the Government do something about it. It is the historic underfunding of health care in north Northamptonshire.  [Interruption.] Does the Minister want to intervene? No. The Leicestershire, Northamptonshire and Rutland strategic health authority is the worst funded SHAin the country, and within the SHA, north Northamptonshire is the worst funded area. How do my constituents stand a chance of having a fair and equitable share of decent health care when we are the worst funded area in the country relative to the capitation formula?

Philip Hollobone: I congratulate my hon. Friend on making a powerful and pertinent point. Is not the position even worse than he describes because north Northamptonshire has some of the sharpest inequalities of any region in the country?

Peter Bone: As usual, my hon. Friend makes a pertinent intervention.
	"We are however the worst funded SHA relative to the national capitation formula which seeks to enable a fair, equitable distribution across the NHS...Indeed North Northamptonshire is our most pressurised health community. Northamptonshire Heartlands PCT which covers this population (including Corby with its severe health problems) is £32 million (9.9 per cent.) below capitation".
	Those are not my words, but those of Sir Richard Tilt, former chairman of the SHA. Funding for the NHS in any area is based on the national capitation allocation formula. That determines what each PCT should get to ensure fair and equitable distribution of funding throughout the country. I have a problem not with the capitation formula, but with the Government's refusal to fund my area with its full capitation amount. Only last week, the Minister of State, Department of Health, the hon. Member for Leigh (Andy Burnham), confirmed:
	"By the end of 2005-06, the PCT was 4.4 per cent. belowits target allocation."—[ Official Report, 28 November 2006;Vol. 453, c. 962.]
	What is the point of a funding formula if one does not stick to it?

Laura Moffatt: I am aware that I need to finish by 6.30 pm. I should like to refer to a couple of points that have not been mentioned—there is little point in rehearsing the arguments that we have heard. I was losing the will to live after the Opposition's opening remarks about public health, given its genuine complexity and their approach to it. I am grateful that many more thoughtful speeches followed.
	We are considering a complex subject, but it is rooted in poverty, ill health and poor housing. The Government are tackling it properly, as they should. I remember only one line in the speech of the hon. Member for South Cambridgeshire (Mr. Lansley) about health inequalities, but on many occasions Labour Members have identified that as the root cause of public health problems in our communities.
	I listened with interest to the hon. Member for South-West Surrey (Mr. Hunt), who was naturally upset about the time that constituents waited for surgery. Of course, that time is much less than when the Conservatives were in power, but we are all missing a point if we do not do the work in our constituencies. However, one should not assume that South-West Surrey is the same as an inner-Manchester seat in the context of public health and waiting times. People in the former come forward much more easily and quickly for surgery—there are definite health inequalities in some of our inner-city areas that we need to tackle. Until we have a proper intellectual debate in this place, that will not happen.
	I was upset to hear many Conservative Members' comments about the fantastic work in our constituencies in the local strategic partnerships. They consider the way in which organisations such as local authorities and PCTs come together to tackle health inequalities in our constituencies. They deal with the fact that there may be huge inequalities in those constituencies and they have to micro-manage some aspects. That is why Sure Start has been so successful in getting into those areas.
	We have heard much about the edifices of health care and how some Members are stuck on having to defend a specific hospital because any closure is perceived as a cut, when innovative thinking is about getting away from such perceptions— [Interruption.] It is difficult. I understand why Conservative Members have to laugh because innovative thinking is the real agenda and they miss the point about, for example, breastfeeding services in our town centres and getting breastfeeding champions out there, and reducing childhood obesity by ensuring that women are able and supported to breastfeed, not in some hospital but in our communities. That work is being carried out in a positive manner.
	The ludicrous to-ing and fro-ing about who hasnot achieved what misses the point about what is happening in many of our communities. The subject is complex, but we must understand the difficulties and why young people risk their sexual health—the madness on the streets—and do not think about protecting themselves. There are myriad reasons for that and today's challenges are different from those of many years ago.
	The new public health challenges are different and need a great deal of thought. The Government are giving them that thought and using evidence to tackle many of the problems. They have stopped the silly to-ing and fro-ing that we get from the Conservative party and are tackling what is happening in our communities.

Andrew Murrison: We have had an entertaining debate this afternoon, although the quality has been mixed. We have heard a total of10 Back-Bench contributions, but before commenting on them I would like to quote Polly Toynbee in  The Guardian newspaper on 12 November.

John Mann: Will the hon. Gentleman give way?

Andrew Murrison: I might in a minute, but I would appreciate it if the hon. Gentleman would allow me to get into my stride.
	Polly Toynbee said:
	"For the first time since polls began, the Tories are winning on the NHS."
	And, just for balance, I would also like to quote Winston Churchill, who, on 2 March 1944, said:
	"Our policy is to create a national health service in order to ensure that everybody, irrespective of means, age, sex or occupation shall have equal opportunity to benefit from the best and most up-to-date medical and allied services available."
	That gives the lie to the assertion by the right hon. Member for Rother Valley (Mr. Barron) that our party does not wish to address health inequalities. Winston Churchill's statement was made in 1944, before the inception of the NHS, and it is clear that throughout the history of the national health service we have been committed to tackling health inequalities, and we will continue to do so.

Kevin Barron: I pointed out a number of issues relating to smoking and ill health and to the attitude of the previous Conservative Government in that regard. The hon. Gentleman was not here at that time, but does he think that those were the actions of a Government committed to getting rid of health inequalities?

Andrew Murrison: I cannot comment on that, but I can comment on the absolute catastrophe of the position taken by the Secretary of State for Health on smoking. We all remember the U-turns involved, and what that did for the debate.

John Pugh: Will the hon. Gentleman give way?

Andrew Murrison: I will in a minute.
	My right hon. Friend the Member for Charnwood (Mr. Dorrell) restored us to a sense of reality withhis magisterial contribution. He clearly shares my sense of disappointment that health outcomes have not matched intermediate outcomes. The Government have done a great deal to address various aspects of public health, and they will have the figures to prove it, but they have not materially improved health outcomes—and that is what we mean by "public health". One director of public health recently told the BBC:
	"When money is tight, it is all too easy to raid public health budgets. In the end, public health loses out, storing up problems for the future. It is depressing."
	It certainly is, as I am sure my hon. Friends the Members for South-West Surrey (Mr. Hunt) and for Wellingborough (Mr. Bone) will agree.

John Pugh: May I ask the hon. Gentleman a question about Conservative policy? I understand that it is their policy to have an independent NHS, yet I gather from today's debate that there would also be public health targets set by politicians. How can they possibly have both?

Andrew Murrison: I am not sure that I fully understand where the hon. Gentleman is coming from. Of course, it is right and proper to aspire to improving public health outcomes, and it is those outcomes that we are focusing on, rather than intermediate outcomes. Had the hon. Gentleman been here earlier to listen to my right hon. Friend the Member for Charnwood, he would have heard that point being explained extremely well.
	Several public health issues have been ably raised by hon. Members today. My hon. Friend the Member for Mid-Bedfordshire (Mrs. Dorries) majored on sexual health, and she was quite right to do so. Ministers have said that by 2008, everyone referred to a genito-urinary medicine clinic should be able to have an appointment within 48 hours. However, as the average wait at the moment is 15 days, it would stretch our credulity to suggest that that target will be met.
	The pièce de résistance is that the Government have not yet launched their £50 million advertising campaign on sexual health. On 11 November, almost two years after the then Health Secretary first announced the campaign, the Minister of State, Department of Health, the hon. Member for Don Valley (Caroline Flint), launched a £4 million advertising campaign to encourage the use of condoms. Asked by the shadow Health Minister Earl Howe where the remaining £46 million had gone, the Health Minister Lord Warner said that
	"it is stored carefully in the coffers of the NHS."—[ Official Report, House of Lords, 21 November 2006; Vol. 687, c. 236.]
	What utter nonsense is that? We all know that the money has not been squirreled away safely in the coffers of the NHS—it has been used to sort out NHS deficits. All the public health money in my area has evaporated in this way.

John Mann: Will the hon. Gentleman give way?

Andrew Murrison: I am not going to give way to the hon. Gentleman; he is wasting his time. He has had his go.

John Mann: On a point of order, Mr. Deputy Speaker. Is the hon. Gentleman out of order in failing to declare his entry in the Register of Members' Interests relating to the Wessex Pharmaceutical Group?

Mr. Deputy Speaker: Order. These matters can safely be left to hon. Members. If the hon. Member for Westbury (Dr. Murrison) had been out of order, I would have stopped him.

Andrew Murrison: I am more than happy to declare my interest if the hon. Gentleman thinks that it is relevant to what I have already said. When I think that it is relevant, I will announce it in the proper way. I am pleased to be an adviser to the Wessex Pharmaceutical Group, which covers a large part of the south-west, which I represent.
	My right hon. Friend the Member for Charnwood referred to the fact that the chief medical officer's annual report states:
	"Raiding public health budgets can kill".
	That gives us the verdict from the horse's mouth.
	Finally, how about the Government's attention to infectious diseases in general? In the year ending31 March 2006, they spent £300 million less than in the previous financial year. What commitment does that show to tackling new and emerging infectious diseases, as well as the antique infectious diseases that have once again raised their ugly heads in our country?
	I want briefly to mention oral public health. The reason that I am interested in this subject is that, two weekends ago, I spent an enjoyable weekend learning how to put in fillings and to treat dental pain. That is something that the Secretary of State knows all about, because it is no longer categorised as a dental emergency. Oral public health means the services provided by dentists in the course of their work to ensure that there are no cancers and to give general advice on health issues. We find that, despite the protestations in the "Choosing Health" White Paper, access to NHS dentistry has shrunk. How on earth is that improving public health?
	The hon. Member for Dartford (Dr. Stoate) discussed raising the age of sale for tobacco, and I am pleased to say that we support this proposal. I seem to recall that my right hon. Friend the Member for North-West Hampshire (Sir George Young) was in the forefront of the argument that the age of sale should be raised to 18, and I entirely agree with him.
	The hon. Member for Bassetlaw (John Mann)talked about substance abuse and asked about the rehabilitation places that we would establish when we are returned to government. Of course there will be a mixed provision of drug rehabilitation places, as I imagine there are under this Government, and I would cite the example of Clouds house in my constituency, which does excellent work in this respect.
	It is essential that our public health policy shouldbe firmly rooted in the evidence. Public health interventions impact on people's lifestyles, and can impact on our personal liberties. It is therefore doubly important that anything that we do in this place should be firmly rooted in the evidence. We must have fad-free public health. It is difficult to conduct large-scale randomised control trials in public health, and the Cooksey review appears largely to ignore the issue. The discipline is bedevilled by its precarious evidence base. The right hon. Member for Rother Valley (Mr. Barron) referred to fruit, and of course fruit is important. My children enjoy it at school, but we have to assess the long-term implications of that policy. It is by no means clear that that particular intervention will be sustained in the longer term.
	On 9 October this year, the Minister admitted that the results of an evaluation conducted by Leeds university in September 2005
	"showed that increased consumption of fruit and vegetables was not sustained when children's participation in the scheme came to an end."—[ Official Report, 9 October 2006; Vol. 450, c. 633W.]
	That is important, and I hope that the Minister will enable more research to be carried out to determine whether this intervention will be sustained in the longer term.
	We do not have evidence of the efficacy of health trainers, as several right hon. and hon. Members have pointed out. There is evidence, however, of the efficacy of abdominal aortic aneurysm screening, as my hon. Friend the Member for South Cambridgeshire mentioned. Between 2,000 and 3,000 lives could be saved each year by that screening, yet I know that the Minister has to date refused to meet the consultants who are conducting the pilot on that intervention, which is a great pity. Annually, that programme could save more lives than are likely to be saved by the smoking clauses of the Health Bill. We need to reflect on that.
	I hope that the Minister will comment on malnutrition among the elderly, about which Age Concern is particularly exercised. If the Minister wants a public health intervention that might work, remedying malnutrition among the elderly—which, scandalously, often gets worse when they are admitted to hospital—would be such an initiative.
	Hepatitis C needs to be addressed urgently. According to the Hepatitis C Trust, we face a public health time bomb. It says that there is a delay in producing a comprehensive strategy to tackle the disease, a failure to ensure that PCTs implement Government strategy once finally produced, and an ineffective awareness-raising campaign. Delay, failure and ineffective—those seem to be pretty good bywords for this Government's approach to public health. The trust wonders why hepatitis C screening is not part of the quality and outcomes framework—and given the scale of the damage likely to be caused by hepatitis C, so do I. It points out that the Department of Health awareness campaign on the subject cost £2.5 million, as against the £280 million spent on persuading people to switch to digital television. The campaign has been a failure, as the number of diagnoses has remained static. The cost of failure is likely to be enormous and I see nothing in the Government's plan for the national health service that will accommodate that failure through investment in hepatology. Given the Minister's failings on public health, she needs to give that close attention.
	Belatedly—I try to be fair when I can do so—the Government have set up the Public Health Interventions Advisory Committee under the auspices of the National Institute for Health and Clinical Excellence. It might start by considering the areas of neglect highlighted today. It might also try to stop up some of the rabbit holes down which consecutive Public Health Ministers have been tempted—chasing headlines, I am afraid, rather than public health.
	Public health medicine needs to be repaired. The hon. Member for Romsey (Sandra Gidley) was concerned about the decline in the number of public health doctors. The chief medical officer tells us that variation in senior public health staffing is unrelated to need and incompatible with Wanless's "fully engaged" scenario. We cannot go back to the position in 1974, when public health doctors were directly employed by local government. We can, however, encourage joint appointments between primary care trusts and local authorities. Directors of public health, however, must hold budgets and have functional accountability to the chief medical officer.
	In public health medicine, what matters is what works. In contrast to Labour's failure, the Conservative party has a proud tradition of effective public health. From Harold Macmillan's home building programme of the 1950s, to our seatbelt legislation that has saved more than 60,000 lives, to the magisterial social marketing campaign of the 1980s that halted the advance of HIV/AIDS in its tracks, we have a pedigree in public health that gives us every right to table this motion.

Ivan Lewis: The Conservative party has no shame whatever. It abolished the word "poverty" from public policy, while allowing it to become a reality for one in three children. Too often, it has cried "Nanny state" when it should have offered responsible leadership. The Conservative Government left behind a battered and scarred society, in which public squalor and human misery were the reality for too many families and communities.
	Increasingly, however, the Conservative party is caught out facing two ways. In response to the announcement by my hon. Friend the Minister with responsibility for public health of an expansion of activities programmes for inactive people, the hon. Member for Hemel Hempstead (Mike Penning) said in yesterday's newspaper that there is a financial crisis in the NHS, jobs are being lost and wards are lying empty, while money is being wasted on this gimmick. "It is a disgrace," he said. However, the shadow Health Minister, the hon. Member for East Worthing and Shoreham (Tim Loughton), said that we have to consider imaginative solutions to get people active. He said that programmes such as "Strictly Come Dancing" have seized people's imagination, and that such a good way of keeping fit could keep people healthy and out of hospital.
	In  The House Magazine, the organisation Forest recently had an advert saying, "No thanks" to the nanny state, which, it says, tells people not to eat, drink, smoke or think. It attacks politicians for having a dialogue with people about responsible approaches to their health. Big government, it says, is watching. It says, "Eat, drink and smoke." At the Conservative party conference in Bournemouth, however, almost 400 people tried to get into Forest's fringe meeting, and hospital staff were forced to turn people away, citing health and safety reasons.
	The hon. Member for Westbury (Dr. Murrison) seems extremely annoyed about the  Health Service Journal publication. He says that it is propaganda. I cannot work out whether it is the photograph of my hon. Friend the Minister with responsibility for public health that concerns him, or whether he is offended by the photograph of feet. The serious point is that using such publications to make the issue relevant and attractive to people is far more effective than boring guidance will ever be.
	In contrast to the Conservative party, the Labour party's very raison d'être is the belief that every individual, irrespective of race, religion or social class, has the right to fulfil their potential. My party has always believed that every child matters, that health care should be available free to all at the point of need, irrespective of ability to pay, and that successful individuals and strong communities march hand in hand in the good society. It is basic to those beliefs that without a healthy life people's aspirations and potential are blighted, and our society and economy suffer.
	We are committed to an enabling state, in which we lead, educate and legislate appropriately, responding to 21st century realities with 21st century solutions. In addition, there is personal and corporate responsibility, with individuals as citizens, parents and opinion formers taking responsibility for promoting healthy lifestyles, and with companies exercising responsibility in the legitimate pursuit of market share and profit margins. We have a proud record, although we always acknowledge that there is a lot more to do on that agenda.
	Let me now address some of the important contributions to the debate from hon. Members on both sides of the House. I always admire the honesty of the hon. Member for Romsey (Sandra Gidley). In a recent debate in the House, she said that she regretted the fact that her party had misled older people and their families at the last election by saying that there was a possibility that they would receive free personal care. We will remember that when we see her party's manifesto at the next general election. She made some serious points about antenatal support and breast feeding. We are proud of our healthy start programme, but it is only a beginning. The Department is working on a new plan for maternity services in this country, which will offer choice to every parent and family in every part of the country. The nature of antenatal support and earliest interventions, such as on breast feeding, are a crucial part of that.
	The hon. Lady launched a strange attack on the virtues of competitive sport. She said that she was worried about young people going back to playing football and hockey. In my experience, thousands of young people around the country play football and hockey and do so happily. I accept that her point about considering the motivation of every individual young person, and giving them the opportunity to be active, is an important one.

James Gray: Will the Minister give way?

Ivan Lewis: No.
	I am always careful about how I respond to myright hon. Friend the Member for Rother Valley (Mr. Barron). I have not yet appeared before the Select Committee of which he is Chairman. He drew attention to the historical scandal of the Conservative party paying scant regard to the question of health inequality. When the Conservatives were in government they actively talked out bans on advertising smoking and the idea of putting health warnings on cigarette packets. They removed nutritional standards from school meals. We all know about the reaction of the hon. Member for Henley (Mr. Johnson), who sits on the Conservative Front Bench, to those parents—possibly constituents of my right hon. Friend—who stuffed hamburgers through school gates, saying that their children should be allowed to eat what they want. The hon. Gentleman said that he fully agreed with them. What kind of responsible action is that from someone who seeks to serve in a Government of this country?  [Interruption.] I know that it is a funny prospect, but there we go.
	My right hon. Friend was also right to point out the contribution made by the voluntary sector in local communities. It is often closer to those communities than the state ever can be in getting messages across and influencing the behaviour of individuals and people with whom it has a daily relationship. The Government sometimes have to be much better at learning how to engage with the voluntary sector to get our messages across to local communities.
	The right hon. Member for Charnwood (Mr. Dorrell) is in denial about his time as Secretary of State. He was one of the people who refused to make the link between inequality and health, and he perpetuated that approach.

Stephen Dorrell: The Minister makes an assertion that is demonstrably untrue from the record. I was frequently asked whether I acknowledged a link between social deprivation and ill health, and frequently said, "Yes,of course I do, and it is one of the functions of the national health service to target resources at eliminating those inequalities." The charge against the Government is that they have not done that effectively.

Ivan Lewis: The right hon. Gentleman was happy to serve in a Cabinet that believed that there was no such thing as society because we are simply a collection of individuals. He was also a pro-European until he sought to be leader of his party. He went to Chequers and gave a press conference, pretending that he had become a Eurosceptic overnight. That is his record.
	My hon. Friend the Member for Dartford(Dr. Stoate) has an impressive track record on public health. He is right to say that the Government have taken a power to raise the minimum age for purchasing tobacco. We have just completed a consultation exercise on that and will respond in due course on how we intend to put that power into practice. He and my hon. Friend the Member for Barnsley, East and Mexborough (Jeff Ennis) have done particularly good work on that.
	My hon. Friend the Member for Dartford also raised the question of alcohol, a modern menace in society. We all accept that we need to take alcohol, and in particular drinking among young people, far more seriously. We are addressing a number of issues relating to that, such as working with the industry on sensible drinking messages and labelling, our know your limits campaign, and screening and brief interventions. We are also working with the Portman Group to appoint a chair and board of trustees of the Drinkaware Trust, which is a voluntary body.
	The hon. Member for Mid-Bedfordshire (Mrs. Dorries) raised several issues, but in none of her contributions has she acknowledged that under-age conception is at its lowest level since the mid-1980s. I would imagine that she would welcome that. I agree with her about the over-sexualisation of children as a result of gaining access to certain materials. I think we would all accept that the media and other opinion formers in society should take a far more responsible attitude to the way in which sex and sexuality are presented.

Graham Stuart: Will the hon. Gentleman give way?

Ivan Lewis: I cannot.
	The hon. Lady should recognise the achievements and the progress that has been made, as my hon. Friend the Member for North-East Derbyshire (Natascha Engel) did. Last week we announced an additional£1 million to strengthen work on our sustained investment in targeted HIV health promotion for groups most at risk. There has been a large drop in the number of AIDS cases diagnosed and a 70 per cent. drop in AIDS deaths because of the uptake of antiretroviral therapies since the late 1990s.
	My hon. Friend said that public health was a hard-core Labour policy. I would not have used that term myself, but I know exactly what she meant. She made a valid point about the work that the Minister with responsibility for public health does every day across government, ensuring that there is a joined-up approach to tackling public health. All too often, that is presented as a sole responsibility of the national health service and the social care system. We need policies across government to tackle social exclusion, and I pay tribute to her work in providing leadership inside the Government and outside in terms of the messages that we give to the general public. My hon. Friend the Member for North-East Derbyshire was also right to raise questions about health education in the school system.
	The hon. Member for South-West Surrey (Mr. Hunt) wants a lot more money to be invested, as he would, but he also wants—let us be clear about this—the measure of health inequality as determining the nature of NHS funding to be removed. That sums up thetrue level of commitment to public health on the Conservative Benches. They want to remove any regard for health inequality as we make decisions about the way in which NHS funding is distributed.
	My hon. Friend the Member for Bassetlaw (John Mann) asked me to look at the healthy living centre in his constituency, and the desire to bring sport and education together. He also mentioned the work of the Do it 4 Real organisation. I am more than willing to consider those issues. He asked questions of the Opposition Front Bench, to which he got no answers.
	The hon. Member for Wellingborough (Mr. Bone) lectured us on the founding principles of the national health service—founding principles that the Conservatives opposed at the time and which they have done everything possible to corrode and undermine when in government. Again, he never says that we are bringing up the levels of primary care trust funding, which historically have been below complement. He complained about historical underfunding. He isright: hon. Members should be concerned aboutthe cumulative effect of 18 years of Conservative Government that led to that underfunding.
	My hon. Friend the Member for Crawley (Laura Moffatt), who has a great track record of having worked day in, day out in the national health service, talked about the importance of local strategic partnerships, recognising that at a local level we need a partnership between local government, the national health service, the voluntary sector and ordinary people—family members—to tackle the problems and raise our game in terms of public health. She made the point that that cannot be the responsibility of one Department, one organisation or one part of society; it has to be a partnership between the state, the citizen, the family and the voluntary sector if we are to achieve our objectives in this important area.
	The Conservatives cannot advocate operational independence for the NHS and no targets, and then claim that they support ring-fenced funding and targets for public health. They cannot portray every reconfiguration as a cut, and then claim to believe in prevention. They cannot adopt economic policies that would mean savage cuts for the NHS and public services, and then claim to be the guardians of public health. They cannot surely keep a straight face in the context of this debate when they propose to scrap health inequality as a key factor in determining NHS funding.
	Public health is as much as anything a generational challenge. We are the party of Sure Start and children's centres; of universal nursery provision; of enhanced maternity and paternity provision; and of parenting support. We are the party of extended and healthy schools; of "Every Child Matters" and every family matters; of the new deal, welfare to work and affordable housing; and of the minimum income guarantee and the winter fuel allowance. We are the party that has transformed heart and cancer care and the party that has banned smoking in public places. We are the Government who brick by brick are rebuilding society, based on a new settlement between an enabling state and responsible citizens. The Conservative party may be led by a man who smiles a lot, but the British people are not stupid. They know that leadership requires a combination of sound values and practical action. A healthy future is built not on a nice smile, but on a commitment to sustained public investment and a long-term attack on social exclusion and inequality. Public squalor is the Tory legacy; public health is an expression of Labour's core values.

Question put, That the original words stand part of the Question:—
	 The House divided: Ayes 217, Noes 296.

Question accordingly negatived.
	 Question, That the proposed words be there added,  put forthwith, pursuant to Standing Order No. 31 (Questions on amendments), and agreed to.
	Mr. Deputy Speaker  forthwith declared the main Question, as amended, to be agreed to.
	 Resolved,
	That this House welcomes the Government's trebling of investment in the NHS by 2008 which is crucial to improving public health and tackling health inequalities; notes that this extra investment has enabled a huge expansion in preventive services including extending breast cancer screening to women aged 65-70 which has helped increase the number of breast cancers detected by 40 per cent. since 2001 and the first ever national bowel cancer screening programme which will detect around 3,000 bowel cancers a year when fully rolled out; acknowledges that this Government has done more than any previous government to help people give up smoking, including banning smoking in all workplaces and public places from1st July 2007; further welcomes the help and support being given to people to live healthier lives including two million 4 to 6 year olds now receiving a free piece of fruit or portion of vegetable, new healthier standards for school meals, clearer food labelling, new health trainers and NHS life checks; and recognises the unprecedented action this Government has taken to tackle the root causes of ill health and health inequalities including helping more people find work, lifting a significant number of children out of relative poverty and taking action to tackle poor housing.'.

Transport Strategy

Mr. Deputy Speaker: I must tell the House that the Prime Minister's amendment has been selected for debate.

Chris Grayling: I beg to move,
	That this House notes that severe congestion on the roads and railways is now very widespread and is significantly worse than it was a decade ago; further notes that the Eddington Report is the eighth major transport strategy document published by this Government since 1997; further notes that in its 10 Year Plan the Government made a series of specific commitments to improve the transport system by 2010 which will not now be fulfilled; further notes that the remit of the Eddington Report was to look at the UK's transport needs after 2015 but that many of its recommendations mirror the Government's now abandoned commitments in the 10 Year Plan; and believes that the UK cannot wait any longer for the Government to keep its promises to ease congestion and improve the transport system.
	Almost 10 years have now passed since this Government came to power. During that time they have promised us an integrated transport strategy, to reduce congestion on our roads—

Mr. Deputy Speaker: Order. I ask those Members who wish to leave the Chamber to do so now quickly and quietly, so that we can get on with the debate.

Chris Grayling: The Government also promised to make our public transport system safer and that we would have a huge expansion of modern, urban public transport systems in our cities and our towns, but, in the end, they have broken promise after promise.
	They started by cancelling road schemes, but then they changed their mind and reannounced them—and then, in many cases, they cancelled them again. They announced a raft of improvements to our rail network and then cancelled most of them as well, or kicked them into the long grass. They unveiled plans for25 new tram and light rail schemes and then cancelled most of them, too.
	There is, however, one thing that they must have done more of in the transport sector than any of their predecessors: commissioned plan after plan, study after study and consultancy project after consultancy project, all in the classic "Yes, Minister" tradition of being seen to be doing something without actually doing anything at all.

Kitty Ussher: If the hon. Gentleman's party were to come to power, would they prioritise rail investment over tax cuts: yes or no?

Chris Grayling: I hope that by the time we have the opportunity to take office the Government will have started some of the rail investments that they promised five years ago. It is a bit of a cheek for a Member sitting on the Labour Benches to lecture and question us about rail investment when the Government have made so many promises that they have failed to deliver.
	That is the big problem with the latest in a long line of grand strategy documents on transport. The Eddington report is the eighth major transport report that we have had from this Government since they came to power nine years ago. We have had multi-modal studies, a 10-year plan and White Papers on roads, rail and aviation. We have had Lord Birt's "blue skies" thinking, "The Future of Transport" and "Delivering Better Transport", and we now have the Eddington report on transport.
	The trouble is that Eddington just seems to tell us things we already knew, such as:
	"Even after accounting for environmental impacts, well-targeted infrastructure options are able to offer very high welfare and GDP returns per £1 of government expenditure with big gains for businesses, freight and commuters."
	It would not have taken my shadow Transport team18 months, a team of civil servants and a seven-figure sum in expenses and staff costs to work that out.

Eric Martlew: I thank the hon. Gentleman for giving way; he is always very courteous—and I am glad that he has his telephone under control today, unlike in a recent debate.
	The hon. Gentleman goes on about policies. The Government's policy on the west coast main line has been successful, but how would his policy of breaking it up and integrating it vertically succeed? There are12 rail companies that run on the west coast main line; how would the policy that he advocates be of benefit to that line?

Chris Grayling: The hon. Gentleman is absolutely right about the benefits of the west coast main line project—I use that route regularly and the service is much improved—but he would do better to spare a moment's thought for Members with constituencies along the Great Western and Great North Eastern routes. Both routes were due to be upgraded as part of the Government's 10-year plan, and both upgrades have been kicked into the long grass.

Brian H Donohoe: Does the hon. Gentleman agree with the shadow Chancellor, who suggests that we should build a Maglev line from Edinburgh to London? Would that be costed in any Tory policy?

Chris Grayling: When the question of a Maglev line was raised, the hon. Gentleman came up with some rather bizarre figures. He claimed that it would cost £100 million per mile to build such a line, which is of course complete poppycock; he really should check his figures more carefully. Anybody who has travelled on the Maglev line in Shanghai could not come away with anything but the impression that we should look at such a project with great interest. We certainly should not automatically reject new ideas without looking at them carefully.
	The Eddington report does not just tell us things that we already know; some parts of it you simply could not make up, Mr. Deputy Speaker. Let us try this one, on page 179, to which Labour Members should listen:
	"Walking and cycling options have the potential for very high welfare returns relative to their cost but may not be enough alone to tackle the true scale of the further challenges facing the UK."
	Whoever wrote that deserves some form of prize and clearly has a bright future as a comedy writer. Of course, there is some good research in the report, but the truth is that after nine years of a Labour Government, Ministers really should be able to do better than producing yet another detailed strategy document, at a time when Britain needs action, not more research.
	I turn to the other major problem with the Eddington report. He is absolutely right to talk about the need for incremental projects, which are the best and quickest way to make a difference—I have been saying that for the past year—but his brief was to look at our transport needs post-2015. Are he and our Ministers seriously saying that we should wait 10 more years before getting the improvements that we so desperately need to ease congestion?
	What about the bigger, long-term vision that so many people in the transport world were expecting, such as a detailed analysis of the high-speed rail option. Of course, the one big idea that Eddington did put forward for Britain post-2015 was road pricing, but as that is already the Government's policy, it is hardly a great breakthrough in thinking. I know that the Secretary of State has been desperately keen to hear the Conservative party's position on this issue and to get some political consensus, so let me finally give him what he has been waiting for, although I fear that I am going to disappoint him.
	I do think that an element of road pricing and the increased use of road charges will be a part of the strategy of any future Government, including a Conservative one, but the Secretary of State and I differ significantly over the scale and pace of any move toward road pricing. Some road-pricing schemes will emerge locally as a result of decision making within an individual town or city; the key is whether they have local consent. It is not the job of central Government to impose them, as this Government are trying to do by threatening to withdraw funding for towns and cities that do not obey their instructions by introducing road pricing. That is happening to cities such as Birmingham and Manchester, which have been left in no doubt whatsoever that if they do not pursue road-pricing strategies, they will lose funding for other transport schemes.

Gisela Stuart: The hon. Gentleman mentions Birmingham. If we are to give local authorities the autonomy to take such decisions, would he not expect them to show at least some leadership? Essentially, Birmingham is saying nothing, and if local authorities cannot make up their minds, the Government are absolutely right to take this approach. Consultation is not simply sitting there saying, "I don't know what to do"; it is telling the people in what way they should proceed. What would the hon. Gentleman tell Birmingham that it should do?

Chris Grayling: I am sure that Birmingham councillors of all parties will be very interested to learn that the hon. Lady believes that the Government should instruct them to introduce road pricing. It is my and my colleagues' view that such measures must emerge locally; they cannot be imposed by central Government.
	The truth is that the only proper role of a Government in such projects should be to ensure proper technological interoperability between schemes in different parts of the country; it would be daft to have a different box on the dashboard for each town or city that one happens to drive into. So if such interoperability forms part of the Government's draft transport Bill, which they will publish shortly, we will support them in achieving that goal.

Richard Burden: I want to press the hon. Gentleman a little further on the question of Birmingham, which is a large urban area and part of a very large conurbation. I understand what he is saying about not imposing measures nationally. Does he believe that an element of road pricing is likely to be part of the solution to Birmingham's transport needs? Does he think that Birmingham should go down that route, or not?

Chris Grayling: The hon. Gentleman is missing my point. Decisions about Birmingham should be taken in Birmingham by Birmingham's elected representatives and its business community; they should not be the subject of debate by national politicians in this place. If we believe in localism, we should stand by that principle and accept that such decisions will be taken locally, and that it is not for national politicians such as me or the Secretary of State to express views on the matter and to seek to impose solutions. We should accept that individual cities know what is in their best interests, and we should not move away from that principle.

Clive Efford: I understand from reading in the press, so I will be corrected if I am wrong, that the Conservatives are suggesting that we have not gone far enough in setting our greenhouse gas emissions targets for 2050. Is the hon. Gentleman saying to the House that if he were Secretary of State for Transport, he would tell a Cabinet meeting, "I cannot deliver on my targets because local authorities, which are responsible for dealing with congestion, are not playing ball and not delivering any strategies to deal with congestion"? Will that be his position?

Chris Grayling: When I am Secretary of State for Transport, I intend to pursue a policy of transforming the technology in our cars by incentivising the purchase of "green" cars, instead of doing what this Government have done, which is to scrap the incentives to purchase such cars. The hon. Gentleman needs to understand that road-pricing schemes are primarily about managing congestion. The truth is that the real challenge in meeting our climate change goals, given that we are not, I assume, moving within the next few years to the kind of national scheme that the Government have talked about—they appear to be backing away from that, although I shall be interested to hear what the Secretary of State has to say later—is the technology in our cars. People are not going to give up driving their cars, even with some form of road pricing; we have to change the nature of the technology in our cars.

Michael Jack: In the light of the comments of Labour Members, does my hon. Friend agree that the real question on road pricing is one for the Government? They need to explain what the£28 billion that the Eddington report identifies could be raised by this mechanism will be used for. So far, they have been entirely silent on whether this is an extra way of raising money, or whether the resources will be channelled into other transport improvements.

Chris Grayling: I give my right hon. Friend a third option—that the money could be put into the general kitty. When the previous Secretary of State first announced the Government's intention to move toward a road-pricing scheme, he talked about one that was fiscally neutral. Since then, both he and the current Secretary of State appear to have backed away from that position. So it is clear that the Government are thinking about road pricing as a revenue-raising measure; what we do not know is whether that money will simply be invested in transport, or whether road pricing is actually a vehicle to generate additional funds for the Treasury.
	We also support the use of road charging to fund transport improvement schemes. The M6 toll road and the Queen Elizabeth bridge over the River Thames at Dartford both offer clear examples of how major projects can be funded, and we will see similar projects in future.
	Thirdly, I want road-user charging for lorries to be put firmly back on the agenda. Such a scheme is essential in order to level the playing field between British and overseas hauliers. Too many of our family-run haulage firms are facing bankruptcy because of a steady loss of business to their counterparts from other parts of Europe, who arrive with a cheap tank of diesel from Calais—often in a vehicle that is not roadworthy—and stay here for a week or two, taking local business. That has got to change. The Government gave a clear commitment to introduce such a scheme, and then went back on their word. This issue cannot be allowed to fester.

Ian Austin: A moment ago the hon. Gentleman spoke about investment in the road network. The Leader of the Opposition said:
	"Britain now needs a concerted programme of road building."
	However, the head of the Conservative policy commission said that
	"there is no doubt about it—there must be an assumption against road building."
	Who does the hon. Gentleman agree with?

Chris Grayling: We have just heard yet another example from the Whips' brief. We believe in debating the issues. Labour Members appear to believe in following the diktat of the Whips Office rather than having a proper policy debate about what is in the interests of this country.
	I want to make one more thing absolutely clear. Road pricing and road charging cannot and must not become yet another stealth tax on the motorists of Britain. Our view is that they should be about congestion management and improving transport, but we will not support the Government in their plan for an early move to a national road-pricing scheme. Indeed, the Secretary of State himself may be back-tracking on the plan. At the past two Transport questions he used the word "if" about a national scheme rather than "when". Perhaps he has realised the risks in taking such a step.
	Apart from the civil rights debates that would have to accompany the introduction of any such scheme, it would probably be the biggest IT project this country has ever seen: tracking every car on every road for24 hours a day; collecting the data, processing it, issuing a bill and collecting the money. As we have noticed, the Government have not had triumphant success in running major IT projects, so for them in particular that one would certainly be a bridge too far.
	The Government are also missing another essential element of any road-pricing strategy. They cannot take steps to price people off the roads without giving them better choices and alternatives. It is simply not good enough to say that people need to change their working patterns to avoid paying more. Are schools to start late or at different times so that teachers can go to work later? Are hospitals to open late so that nurses and porters can avoid the rush hour? If there is to be increased use of road pricing as a means of managing congestion, public transport improvements must come first. That is where the Government seem all at sea in their plans for the future, and where Sir Rod's focus on incremental improvements, in a report about 2015 and beyond, seem so misplaced.
	The problems are today, not in 10 years' time. The country needs action now to deliver the changes that are needed.

Paul Rowen: In the light of what the hon. Gentleman has just said, will he tell us what Conservative policy is on buses, particularly with regard to deregulation. They deregulated the buses and bus use dropped, so what will they do to get more people using buses?

Chris Grayling: As we are about to hear the Government's proposals, I shall wait for them and react to them. Sadly, unless something dramatic happens, we will have to wait another three years for a chance of getting into government, but I assure the hon. Gentleman that we will have detailed plans beforehand. In the meantime, I am waiting, with a degree of bated breath, to hear what the Government plan to do. They have been raising the expectations of the bus industry and, indeed, of local authorities, so it will be interesting to hear what they come up with. I have a sneaking suspicion that it will prove rather disappointing to those who expect something substantial from this Administration.
	We were supposed to have those public transport improvements. The Government had great intentions. Their 10-year plan was supposed to be a blueprint for improvement. It said:
	"Transforming our transport networks and tackling the legacy of under-investment is vital for this country's economic prosperity. It requires a ten-year approach. Major transport projects take time to develop and implement. With some problems, notably congestion, current trends will take time to reverse. And major investment in infrastructure will inevitably cause disruption while work is being done to achieve our targets for 2010.
	Our aim is ambitious: it is to benchmark our performance against the best in Europe and, through greatly increased investment, to transform our transport infrastructure over the next ten years."
	If the plan had been seen through, it really would have made a difference. There would have been major improvements to our suburban rail networks. Both Thameslink and Crossrail would have been delivered by 2010. There would have been upgrades of most of our major inter-city rail routes and a step change in urban public transport, with new light rail systems in most major cities, yet we are almost in 2007, with most of the plans on the shelf, in the long grass or forgotten.

Martin Linton: rose—

Chris Grayling: Perhaps the hon. Gentleman wants to tell me whether he is proud of his party's success with its 10-year plan for transport.

Martin Linton: The hon. Gentleman suggests that there were no public transport improvements in London before road charging. Perhaps he should visit Chelsea road bridge in my constituency, which two years ago was used by only one bus route, but because the congestion charge zone will be extended in February there are now four bus routes—an increase of one to four before the congestion charge.

Chris Grayling: Is the hon. Gentleman aware, first, that bus ridership in London is falling significantly, and secondly, that the subsidy required to run London's buses has risen fivefold, to a total in excess of £500 million a year? Many Members who represent other cities would love to have access to that sort of finance for their bus networks.

Jim Cunningham: The hon. Gentleman mentions subsidies. What would his party do about them? Will they increase them or cut them as they did when they created the mess we have now?

Chris Grayling: I am intrigued by the fact that although the subsidy has risen, passenger ridership is falling in London. I realise that the hon. Gentleman is very excited at the prospect of seeing the next Government's transport policies, but he will have to wait a little longer for the details.

Jacqui Lait: My hon. Friend was talking about the impact of congestion. Even before the introduction of the zone system or any improvements in the service, my constituents who travel on the Hayes line will have to pay a fare increase of between 50 and 75 per cent. What effect does my hon. Friend think that will have on road congestion?

Chris Grayling: My hon. Friend is right. Her constituents are not alone in experiencing substantial fare rises. Last week, the Association of Train Operating Companies announced wide-ranging fare increases that will undoubtedly decide some people to drive to work rather than taking the train. That is happening as a result of the way that the Government are managing the franchise system. Ministers have taken back such close control of the day-to-day operation of the railways that they cannot deny responsibility for the current fare increases.

Louise Ellman: Will the hon. Gentleman give way?

Chris Grayling: I want to make some progress. I have taken up a lot of time and other Members want to speak.
	In the document we published last week, we setout a number of areas where we think transport improvements must be a priority. We will need to improve transport capacity for commuters into and around the City of London and Canary Wharf. The future of London as a major financial centre is of paramount importance to our economy. The capacity challenges on our rail networks, in particular, represent a brake on the future growth of London, and must be addressed.
	We need to address the question of transport provision in designated growth areas in the south-east, such as the Thames Gateway, if the major development plans for those areas are to go ahead. It would be utterly untenable to pursue development on the scale envisaged without adequate provision of transport infrastructure. As a Kent MP, the Minister of State, the hon. Member for South Thanet (Dr. Ladyman), must understand that. I continue to be amazed that the Government have completely failed to understand the inability of the infrastructure in the south-east to cope with the scale of development they are planning.
	At the same time, we need a renewed focus onthe trans-Pennine links between Liverpool, Greater Manchester and west Yorkshire. Congestion on key arteries in the north-west and west Yorkshire is one of the key transport challenges we face. Failure to address the problem will act as a brake on the economy of the two areas, and will also have an adverse effect on quality of life.
	There is inadequate capacity on transport links to the west of England and the economy of the west country is clearly affected by the limitations of the infrastructure in and out of the region. The Labour Government have not focused sufficiently on measures to improve the situation.
	We also need to address congestion in and around Birmingham—the hon. Member for Birmingham, Edgbaston (Ms Stuart) knows well what a problem it is. As well as being one of our biggest urban and business centres, Birmingham suffers from being a major junction point on both our road and our rail networks. There is an urgent need to deal with the problems that combination presents.
	We must not forget access to public transport in rural areas, where it is extremely limited in too many places. The Government seem set on reducing, or even closing, rail services in the areas that escaped the Beeching cuts.
	In the past few weeks, and during this debate, Labour Members have been leaping to their feet to demand detailed information about future Conservative plans. I can tell them that those regional priorities are issues for today—not for the next general election, in perhaps three and a half years time, but today. I hope the Government will get on with the job now. If they do not, my colleagues and I will be delighted to pass on a message about government in action to the electorate in those areas.
	Transport has been a model case study of the failures of the Government. There have been good intentions and high sounding words about the need for improvement, there has been seemingly endless planning and strategising, and there have been big increases in budgets, but the reality on the ground, out in the country, is that promised improvements are simply not coming to pass. It is not that nothing has got better. After the amount of money that the Government have spent, I would have been horrified if nothing had changed. There have been some improvements. The west coast main line is an example. However, the things that have happened are only a small part of the long list of promises that have been made and have not been turned into reality. Britain is becoming more and more congested by the day. Let us make Eddington the last report about our transport needs. Let us stop chewing over all the things that need to be done. It is time that Ministers actually got on with the job.

Douglas Alexander: I beg to move, To leave out from "House" to the end of the Question, and to add instead thereof:
	"welcomes Sir Rod Eddington's independent report on the impact of transport decisions on economic productivity and growth; accepts his findings that the UK transport network provides the right connections, in the right places, to support the journeys that matter to economic performance, but also that the current unprecedented period of sustained economic growth will continue to place increasing pressures on key sections of that network, and that this needs to be addressed with a wide-ranging strategy encompassing better-use and investment solutions; supports the Government's commitment to taking the decisions which will be required to meet these pressures and put UK transport on a sustainable footing, including tackling the environmental impacts of transport, piloting road-pricing and building on the improvements in rail performance; acknowledges the progress already made through sustained long-term investment and forward planning through the Future of Transport White Paper; and recognises the substantial increases in capacity which this approach has brought, and the continuing programme of investment to provide further increases in capacity and reliability in future."
	I will deal with the points raised by the hon. Member for Epsom and Ewell (Chris Grayling), but let me begin by expressing my gratitude to him for giving us yet another opportunity to debate transport strategy and giving me the opportunity to point out to the House the difference between the Government and the Opposition. The difference, as was transparent from his contribution to the debate, is that we have a strategy. Indeed, he admitted in an interview published on9 March this year that the Tories have not had a transport strategy since 1997—although it is rather generous to suggest that they had one before that.
	The hon. Gentleman told  Local Transport Today—no doubt a publication with which all Members of the House are familiar—that he and his colleagues have adopted a series of "tactical positions", rather than a strategy. And my, what a variety of tactics they have used! If it is the right hon. Member for Suffolk, Coastal (Mr. Gummer), the answer to congestion is a presumption against road building. That is what he said in January to the  Daily Mail. If it is the right hon. Member for Witney (Mr. Cameron)—speaking only a few months earlier, on 8 November, to the Centre for Policy Studies—it is a concerted programme of road building. If it is the right hon. Member for Wokingham (Mr. Redwood), it is notjust road building, but building double-decker carriageways—according to his 10-point plan for the Conservative party's competitiveness commission. That is before the hon. Member for Epsom and Ewell gets a word in edgeways.

Martin Salter: I welcome my right hon. Friend. He has highlighted the commentsof the right hon. Member for Wokingham (Mr. Redwood), but he has forgotten to inform the House of the jewel from the right hon. Gentleman, whose answer to climate change—I do not know how this fits into the new green policy—is to build higher sea walls. Does my right hon. Friend share that approach to climate change?

Douglas Alexander: If I start describing the jewels in the crown of the right hon. Member for Wokingham, I fear that I will make little progress, so let me continue.
	Last Friday, Sir Rod Eddington published 400 pages of closely argued analysis of our transport network and the capacity and congestion challenges that we face. In response, the Conservatives published what they call a transport strategy document, which amounts to a whole 17 pages. Five of the pages are dedicated to what they describe as
	"illustrative examples of the kind of people who are affected by the Government's failings on transport and are not real case studies".
	 [ Interruption. ] They were quite literally made up. That is not a real strategy from the Conservative party. I am tempted to say that the Opposition could not make it up, but they have had to make it up because, as has been transparent in the debate, they do not have any policies.
	The Opposition can table as many motions as they like and seek as many debates as they wish, but they will never develop credible plans for transport unless they commit to the means as well as the ends, by committing themselves to a programme of sustained investment. That is the first fundamental difference between us and the Opposition. A commitment to sustained investment is the foundation of the Government's approach to the transport challenges that we face.

Pete Wishart: May I apologise to the Secretary of State? For the past few months, we have been referring to him as a part-time Secretary of State for Scotland, but that is clearly not true any more. He is a part-time Secretary of State for Transport. As our railways and roads descend into chaos, he has, in effect, taken a sabbatical to run the desperate and hysterical Scottish campaign for the Holyrood election. Surely with the problems and issues that we have in our transport system, we need a full-time Secretary of State for Transport here.

Douglas Alexander: I can assure the hon. Gentleman that it does not take much time, or share of mind, to come up with arguments against nationalism.
	The decisions that we have taken on macro-economic policy since 1997 mean that the UK economy has been stronger and more stable than any other major economy in the world. That has allowed us to invest more in our transport system. All that stands in stark contrast to the Conservatives' 18 years in government, which saw two of the deepest recessions of the last century and therefore a policy of stop-go funding in relation to transport, with year-on-year budgets and arbitrary cuts to transport spending. By contrast, by next year transport spending will have increased by more than 50 per cent. in real terms above its level in the last year the Conservatives were in office.

Andrew Turner: I understand that one of the ways in which some of that expenditure will be used is to allow for a national programme of local bus concessionary fares. Will the right hon. Gentleman explain why the Department for Transport has not costed extending that scheme to ferries?

Douglas Alexander: I know that that issue is of particular concern to the hon. Gentleman. In terms of the allocation of resource that has been made available in relation to the extension of the concessionaryfare scheme, originally we committed £350 millionto the local concessionary fare scheme. The national concessionary fare scheme involves an extra£250 million of resource, which has been allocated. I am certainly aware—not least in the light of the earlier contribution—that there are other parts of the United Kingdom where concessionary fare schemes apply to ferries. If that in an example of an area where he is now convinced of the merits of devolution, that is an example of a sinner repenting. Spending on localbus services has gone up by 75 per cent., or more than £800 million a year, in real terms.

Gary Streeter: Will the Secretary of State give way?

Douglas Alexander: I will make a little progress and then I will be happy to take interventions.
	Local transport investment has doubled, increasing by £700 million in real terms. Let us not forget that the Opposition have voted against every single Budget since 1997. The hon. Member for Epsom and Ewell might plead for action—that was a central theme of his speech—but he knows, as I know and as the country knows, that, for all his empty pledges, his party's policy on transport is the same as it is for health, education, and law and order, and in every area of government. It is not "something needs to be done," which is what he sought to advocate this evening, but "£21 billion of cuts need to take place."

Chris Grayling: Is that the best you can do?

Douglas Alexander: It is not, actually. I will come on to the best that I can do, and the comments of the hon. Gentleman's deputy, the hon. Member for Wimbledon (Stephen Hammond), in a moment.
	In case there is any doubt about the Opposition's position on £21 billion of spending cuts, the endorsement of the hon. Member for Tatton (Mr. Osborne), the shadow Chancellor, should dispel them. The shadow Chancellor said, at the launch of the Conservative's tax commission report on 18 October:
	"The framework for our tax policy is now set".
	The hon. Member for Epsom and Ewell urged me to give further evidence as to the line of argument that I was pursuing. It therefore seems appropriate to turn to the contribution of his deputy, made only today on a Conservative website.

Gary Streeter: Will the Secretary of State give way?

Douglas Alexander: No, I am keen to make a little progress, because I think that all Opposition Members will be interested in this point. Where do the transport spokesmen on the Conservative Front Bench stand on the issue of investment for transport? Only today, no doubt in anticipation of this evening's debate, the shadow Transport Minister, the hon. Member for Wimbledon, called for corporation taxes to be cut to15 per cent., at a cost of more than £20 billion, and small business taxes to be cut to 10 per cent. I can understand why, after years of underinvestment, a botched privatisation, neglect of the bus network and cuts in the roads budget, the hon. Member for Epsom and Ewell had so little to say about his party's record in government. However, on reflection, perhaps the reason why he said so little about his present transport policy is that he has so little money to spend. He cannot, with any credibility, will the end on transport, but not commit the means.

Jeremy Browne: I wonder whether the Secretary of State is being uncharacteristically mean-spirited towards the hon. Member for Epsom and Ewell (Chris Grayling), who had an impressive list of aspirations for transport policy. Has the Secretary of State costed those aspirations?

Douglas Alexander: Again, if I start trying to cost the uncosted wish list of the Opposition, I fear that no Back Bencher will be able to contribute to this evening's debate.

Gary Streeter: May I ask the Secretary of State a question about his policy? In many of the rural partsof my constituency, access to public transport for vulnerable and elderly people is becoming increasingly difficult. I know that he is enjoying a bit of political knockabout, but this is a serious opportunity for him to answer a serious question. What policy is he going to pursue to make sure that elderly, vulnerable, isolated and alienated people in my constituency have better access to public transport? It is no good giving them concessionary fares. There are not enough buses for them to get on.

Douglas Alexander: We are spending more than £2 billion on supporting bus services in the country, but it is right to recognise that there are questions about the governance arrangement for buses. That is why I will make a further announcement in the weeks to come.

Andrew Gwynne: Earlier this year, we heard an apology from the Conservative party for rail privatisation. Was my right hon. Friend as surprised as me that the speech madeby the hon. Member for Epsom and Ewell (Chris Grayling) included not one reference of regret for the Transport Act 1985, which stripped passenger transport authorities of the powers to regulate bus services and decimated services in places such as Greater Manchester?

Douglas Alexander: Yes and no. I was not surprised that the hon. Member for Epsom and Ewell chose to sit on the fence. However, it might be a long time before we get an apology. The Conservative spokesman has asked the right hon. Member for North-West Hampshire(Sir George Young) to advise him on restructuring the Department for Transport. In case hon. Members have forgotten, the right hon. Gentleman was, of course, the Secretary of State for Transport who rushed through the sale of Railtrack and cost the taxpayer millions of pounds. Despite the public protestations and apologies that we have heard from Conservative Members, I am not sure that they have learned many lessons, as I shall make clear when I speak about rail.
	We are strengthening the performance and reliability of rail. We will provide extra capacity for a now growing railway and we will meet the environmental challenge.

Gisela Stuart: As the Secretary of State is talking about the railways, may I entice him to give a commitment that the Government will fully support the Birmingham gateway project, which will allow us to rebuild New Street station?

Douglas Alexander: If I am not able to give such a pledge this evening, let me at least offer some words of encouragement. The Under-Secretary of State for Transport, my hon. Friend the Member for Glasgow, South (Mr. Harris), visited Birmingham New Street station last month with Network Rail and saw the need for improved facilities. In the months to come, in the context of the high-level output statement that we will be making next summer, we should be able to make a specific announcement on the facilities in Birmingham.
	Under Labour, we now have the fastest growing railway in Europe. More than 1 billion rail journeys are made every year. Just last Monday, Network Rail published its interim results, which show that punctuality is at a seven-year high, that more than£1 billion has been slashed from the costs of running the railway, and that continued high levels of investment are making a difference. Passenger numbers are up by 40 per cent., and freight has grown by 60 per cent. over the past 10 years, while safety is improving. As a result of the sustained investment that we are putting into the industry—we are spending some£88 million a week—we have already replaced over40 per cent. of rolling stock since 1997, which has made our fleet one of the youngest in Europe.

Jacqui Lait: Will the Secretary of State tell me how the number of rail passengers will increase, given that the Under-Secretary of State for Transport, the hon. Member for Glasgow, South (Mr. Harris), has instructed that fares on the Hayes line should go up by between 50 and 75 per cent. and that that should start in January—before any service improvements have been made and before the introduction of the zonal system in London?

Douglas Alexander: I assure the hon. Lady that we support the zonal fares system. I think that the system has won widespread support throughout the capital because of the simplification that it offers. If any Conservative Front-Bench spokesman wishes to take this opportunity to put on the record their opposition to zonal faring, I will be very interested to hear them, as will many commuters in London.
	It is against the backdrop of sustained investment that, for the first time, the Government will next year publish fully costed and independently agreed proposals for rail for the next five years. Those proposals will be set in the context of an even longer-term framework. In contrast, we are now beginning to discover just how little the official Opposition have learned from the botched privatisation that they inflicted on the railways. Far from apologising for rail privatisation, the Conservative party has in fact learned nothing from it, as we can see from its latest so-called strategy document that was published last week, which includes plenty of warm words about integrated organisations. Just as the Tories botched rail privatisation in the 1980s by fragmenting the network, they are now apparently proposing a further fragmentation by breaking up Network Rail. The party that broke up the rail network now proposes new plans to fragment the railways further. Its message to the public seems clear: "Sorry we took a mallet to the railways. Do you like our new mallet?"

Daniel Kawczynski: I am grateful for the help that the Under-Secretary of State for Transport is giving to secure the direct rail link between Shrewsbury and London. However, there are still a lot of problems relating to the maintenance of the railway. Network Rail and the train operators each blame the other for not taking responsibility for maintaining our station. Will the Secretary of State give clearer guidance on who should do what regarding the maintenance of railway stations?

Douglas Alexander: Of course, joint control centres between train operating companies and Network Rail have been established in recent years. The hon. Gentleman makes a genuine and heartfelt plea for improvements to his constituents' service, but I struggle to see how the scale of expenditure cuts proposedby his Front-Bench colleagues would help the Conservative party's endeavour to solve such problems at any point in the future.

Chris Grayling: When the right hon. Member for North Tyneside (Mr. Byers), a former Secretary of State with responsibility for transport, said that one of the weaknesses of rail privatisation was the lack of an interface between track and train, was he wrong?

Douglas Alexander: It is for that exact reason that joint control centres are being established to ensure that Network Rail can work effectively with the train operating companies. The hon. Gentleman should keep pace with the changes that have taken place, rather than reading speeches made by former Secretaries of State.

John Barrett: rose—

Douglas Alexander: I have been generous, but I will give way to the hon. Gentleman.

John Barrett: Will the Secretary of State comment on the lack of enthusiasm for high-speed rail linksin the Eddington report, bearing in mind the opportunities that they would offer for the future of this country's rail transport system?

Douglas Alexander: A characteristically costed view from the Liberal Democrats. Mr. Eddington—[Hon. Members: "Sir Rod."] Sir Rod Eddington struck an appropriate balance by recognising that when one considers the strategic view of Britain's transport needs in the decades to come, one should not start with a modal solution, but say, "Where are the networks and what are the opportunities for improving them?" That is the context in which we will take forward our analysis of the case for a high-speed rail line in the months ahead.

Louise Ellman: Will the Secretary of State give a commitment to invest in our railways to deal with increased demand? Does he accept that the problem has been caused by the Government's success in growing our economy and turning round the disaster of Tory rail privatisation?

Douglas Alexander: I concur absolutely, as does Sir Rod Eddington when he recognises that we are dealing with the symptoms of success. We have brought stability not only to the rail industry, following the Conservative's botched privatisation, but to the economy. The stability of the economy is the basis on which we are able to secure investment. The fundamental difficulty for Conservative Members is that they cannot will the ends without willing the means. They are ideologically determined to impose tax cuts and massive public spending cuts, yet their record of economic stewardship suggests that they would not be able to run the economy, even if they were minded to put in place the kind of investment that we have seen in recent years.
	On the roads, our approach is to provide better real-time information for road users, to strengthen the management of the existing road network, to target investment where it is warranted, and to work with local authorities on road pricing pilots to tackle congestion in local areas. In a recent debate in the House, my right hon. Friend the Home Secretary responded to his shadow by declaring:
	"consistency is the hobgoblin of small minds".—[ Official Report, 23 November 2006; Vol. 453, c. 708.]
	That phrase came to mind during a single paragraph of my opposite number's speech when he said not only that we needed decisive action, but that he wanted slower action on road pricing. That does not sound like the most consistent policy that I have ever heard from the Conservative party.
	More than 1,100 traffic officers are now deployed across the motorway network to help to assist traffic flow after accidents and incidents, and the national traffic control centre and the seven regional control centres monitor our motorways to keep traffic moving and congestion to a minimum. However, with nearly33 million vehicles now on our roads, compared with 26 million in 1996, and given that the number of cars has gone up by about 60 per cent. in the past 20 years, a position of simply building more roads is not tenable.
	After decades of neglect and underinvestment, the Government have tried not just to right the wrongs of the past, but to build a transport system that is fit for the challenges that lie ahead in the 21st century.

Paul Rowen: The Secretary of State has not mentioned light rail. Given that his predecessor cancelled several such schemes—Manchester Metrolink is the only one that is going ahead—will he tell us the future that he envisages for light rail?

Douglas Alexander: Again, the hon. Gentleman should keep up to date. Not only did I give the go-ahead for £450 million of investment for the Manchester Metrolink, but we have taken forward proposals on the extension of the Nottingham trams. It would be probably be helpful if he would keep up to date with the announcements that come out of the Department.
	Our policy is to build on the firm foundations of the greatest period of macro-economic stability this country has enjoyed for generations, by contrast with the shifting sands of the slash-and-burn economicsof the Conservatives. Now, our challenge, in the words of Sir Rod Eddington, is to deal with the symptoms of success—the symptoms caused by the longest sustained period of economic growth in our history. We shall introduce plans to pilot road pricing, to give us the evidence that we need on the role of road pricing in tackling congestion. We shall continue the sustained investment that has turned our railways from being the sick man of Europe under the Conservatives into the fastest growing railway in Europe. We shall work to ensure that every part of the country has the ability to deliver public transport services, including bus services, that are right for their communities.
	I am grateful for the Opposition's tactical decision to give me the opportunity to outline the Government's approach to sustained investment, effective management and planning for the future. I commend the Government amendment to the House.

Alistair Carmichael: The main thrust of my comments will relate to the Eddington report, which is an interesting piece of work, and to the Government's record on transport after some nine and a half years in power. However, it would be remiss of me not to make some reference to the motion that stands in the name of the hon. Member for Epsom and Ewell (Chris Grayling) andhis right hon. and hon. Friends, which is a quite remarkable piece of work.
	The kindest thing that I can say about the motion is that it is long on analysis, but rather short on solutions. The hon. Gentleman and his colleagues are right to identify road congestion as a major problem for our transport network, and they are right to identify the capacity problems experienced by our railways. They would have been right to identify the problems of declining bus use outside London, and it is remarkable in every sense of the word that they did not do so. It is quite remarkable that the party of Polly Toynbee has nothing to say about the mode of transport that is most widely used by the poorest in society.
	It is also remarkable that the born-again environmentalists on the Conservative Front Bench do not make a single reference in their motion to the Stern report. I have to tell the Secretary of State that the same fault can be seen in the Government amendment. The Liberal Democrats recognise the contribution that transport makes to carbon emissions, and we believe that to attempt to read Eddington on its own, without some reference to Stern, is a sterile effort.
	Although the Conservatives do not have much to say about what they will do or would do in government, they could say an awful lot more about what they did. If our trains are failing, it surely has more than a little to do with the way in which our train system was privatised. If our bus services are failing, it has more than a little to do with the way in which they were deregulated in the 1980s. If our roads are congested, that is surely a result of the Conservative Government's view that we could build our way out of congestion. The Conservative position on road user pricing as outlined tonight is quite the most remarkable piece of work of all. It reminded me of the maiden's prayer, "Lord, make me chaste, but not just yet."

Peter Atkinson: I take it that the hon. Gentleman has carefully read the Eddington report. He might have touched on the section about bus services and deregulation, where Sir Rod notes that there has been a 50 per cent. decrease in operating costs and
	"considerable innovation in the bus market following deregulation, including improvements in bus fleet, variable bus sizes, out-sourcing of maintenance, smart ticketing and the introduction of parttime working arrangements for employees in the sector."
	I think that that is a fairly good commendation of the deregulation of bus services.

Alistair Carmichael: The hon. Gentleman cannot get away from the fact that since bus deregulation, bus use, which is highest among the poorest in our society, has consistently decreased. There was something almost distasteful about the glee with which the hon. Member for Epsom and Ewell spoke about bus use now beginning to decrease in London.

Kelvin Hopkins: The hon. Member for Hexham (Mr. Atkinson) suggested that profitability has increased, but of course it does if after deregulation bus services only run on the cherry-picked profitable routes. What about service to passengers?

Alistair Carmichael: The hon. Gentleman points tothe crux of the matter. I am not advocating a return to the pre-1986 position and I doubt that anyone in this House is. However, the way in which deregulation was carried out by the Conservative Government left no scope for local accountability. The passenger transport executives and the passenger transport authorities have been stripped of any meaningful power, which has had a severe impact on their standing within their communities. It is to that level of local accountability that we wish to return.

Paul Truswell: Does the hon. Gentleman agree with my summary of the intervention by the hon. Member for Hexham (Mr. Atkinson), which is that the operation was successful but the patient died? As the hon. Member for Orkney and Shetland (Mr. Carmichael) says, buses account forthe vast majority of passenger journeys, yet the Conservative spokesman did not mention them. In west Yorkshire, seen passenger journeys have decreased by a third—100 million passenger journeys—and fares have increased by 50 per cent. Routes have been chopped and changed and pared down to suit the interests of shareholders, rather than the needs of communities.

Alistair Carmichael: What we are seeing is the different attitudes to bus services. I see tremendous value in terms of economic regeneration, the environment and social inclusion in investing in bus services and giving meaningful support and accountability to local communities in their provision. Let us not forget that Baroness Thatcher said that any man over the age of30 who used a bus to get to work should consider himself a failure. She has been silent on her view of men over the age of 30 who go to work on a bicycle.

Chris Grayling: Can the hon. Gentleman explain why the decline in bus passenger ridership was faster before deregulation than it has been since?

Alistair Carmichael: I made it clear that we are not saying that the position pre-1986 was perfect. We are saying, however, that there has been a removal of investment and of local accountability. The hon. Gentleman seemed to be preaching that people in Birmingham should be the ones who decide on road user pricing. Why should bus services not be treated in the same way?
	The one point of agreement between us and the Conservatives is on the starting point of Rod Eddington's report: 2015. There is a need for immediate action to tackle the crisis in our transport system. We accept that the Government have invested in our transport infrastructure, and that is welcome. We acknowledge the improvements that have been made, such as on the west coast main line. However, their record after nine and a half years is less than impressive. Rail delays have doubled since 1997, people feel less secure on our transport system—only 7 per cent. of stations were awarded secure status—and under the Labour Government the real cost of motoring has actually decreased while the cost of travelling by train or by bus has increased.
	In our view, the problem at the heart of the Government's approach has been the overweening centralisation, with micro-management from the centre. Because of that, they are bound to fail. I had an interesting meeting last week with a representative of one of the rolling stock companies, who gave me an insight into the way in which the Government now approach the provision of rolling stock. He told me that the north-west franchise currently operates with 10-carriage trains; predicted growth is such that the ROSCO wants to provide 12-carriage trains, but the Government are blocking that and insisting on an increase to only 11-carriage trains. It seems bizarre. The ROSCO wants to provide the rolling stock and the train operating company wants the ROSCO to provide the rolling stock. Surely, the role for Government should be to get out of the picture and let them get on with it.
	In other franchise areas we see the nonsense of train operating companies removing seats to cram in more passengers, which the  Evening Standard recently called, rightly, the "cattle truck policy". We have the most expensive train services in Europe, but Government policy seems to be just to keep cramming in passengers. The Secretary of State will never achieve the necessary shift to public transport if we continue to provide a second class service at a first class price.
	It is our view that there is much in the Eddington report that is good and useful. In particular, the analysis of the case for road user pricing as "an economic no-brainer" is exceptionally welcome. I hope that it serves as a stimulus to the Government to act, and to act early. I am grateful to the Secretary of State for making Sir Rod Eddington available to meet me and my colleagues yesterday afternoon. It was an interesting and instructive session.
	In the course of that meeting I was struck by the fact that Sir Rod said repeatedly—he is on the record as saying this—that his report is the start of the process, not an end point. I cannot help but wonder whether the report has been misshapen by the terms of its remit, commissioned as it was by the Treasury, with the emphasis on the economic contribution of transport.

Pete Wishart: Does the hon. Gentleman share my surprise that the former chairman of British Airways favours expansion of British airports?

Alistair Carmichael: I was not particularly surprised, but I was rather disappointed. I shall say a little more about that later. In fairness to Sir Rod, it should be said that the expansion that was envisaged was not even to British airports. It was to Heathrow, particularly the construction of a further runway there.
	On the remit, before the Stern report, the Eddington report would have been unexceptional. Post-Stern, the emphasis and reliance on economic benefits is an exercise in looking at the matter through the wrong end of the telescope. There should have been a much stronger focus on the environment, especially on the reduction of carbon emissions. When one finishes reading the report, it is not clear what effect transport would have on carbon emissions if everything that is proposed in the report were acted on.
	I welcome the placing of a cost on carbon. Sir Rod settles on the figure of £70 per tonne. On reading the report, it strikes me that that figure is chosen because it is the mid point in a Treasury estimate. A great deal more work needs to be done in this area, and I hope the Secretary of State will view it as unfinished business—part of the process, as Sir Rod said, rather than the end point.
	I also welcome the acceptance by Sir Rod that aviation should pay its way in terms of its carbon cost. I do not see how we can regard the present taxation regime in aviation as being in any way sustainable. It is bizarre that we tax passengers through air passenger duty, but not freight. Surely the plane pollutes just as much, whether it is carrying freight or people. Indeed, freight probably pollutes more, because it tends to use older, more polluting aircraft. The Eddington report contains much good analysis of that sort, but still ends up with the conclusion that we need an extra runway at Heathrow.

John Pugh: In his discussions with Sir Rod, did my hon. Friend find out why he said so little about Crossrail, but quite a lot about high speed rail links to the north?

Alistair Carmichael: We touched briefly on the question of Crossrail, which I know is a matter near and dear to my hon. Friend's heart, who struggles on the Crossrail Committee. Whatever is stated in the report about Crossrail is fairly supportive of the concept—that is, Sir Rod Eddington is supportive of the concept, but again, he recognises that there is a substantial financial commitment to be made by the Government. There is not much point in getting too excited about Crossrail unless and until that commitment is made. The report was, perhaps, a missed opportunity in that respect, as it was commissioned by the Chancellor. Something more trenchant on the subject of Crossrail might have elicited a rather more detailed and meaningful response from the Treasury than we have had to date. However, we have the pre-Budget report tomorrow, and who knows what we might learn then.
	In relation to the conclusion about the extra runway for Heathrow, I much prefer the view of Stephen Joseph of Transport 2000, who said:
	"Eddington's insistence, with Nicholas Stern, that aviation should pay its full environmental, social and economic costs make the Government's 'predict and provide' approach outdated. By 2050, aviation will account for 46 per cent. of UK carbon emissions."
	It is not lost on me, at least, that Eddington's starting point in relation to aviation is an acceptance of the Government's White Paper. I do not share that acceptance. I think that the aviation White Paper is deeply flawed. It is remarkable that Eddington was prepared to take it as his starting point, when the Secretary of State is currently engaged in what purports to be a review of that White Paper. I wonder whether Sir Rod Eddington had some steer as to the likely outcome of the Secretary of State's review.

John Thurso: Does my hon. Friend agree that in the light of the Stern report, it is impossible to accept the Government White Paper as the way forward for aviation, which we know will become one of the biggest emitters of carbon gases? Does he share my view that the Government must reflect again on that, in the light of Stern's comments?

Alistair Carmichael: Indeed. I would not depart from that view in any way.

Douglas Alexander: Can the hon. Gentleman reconcile that argument with the position of his own constituency Member of the Scottish Parliament—the Transport Minister in the Scottish Executive—who is on record as celebrating the additional air routes out of Scotland, using public money to achieve that?

Alistair Carmichael: That is a good example of the way that devolved government in Scotland has used a bit of imaginative and lateral thinking in order to take some of the pressure off Heathrow. By growing routes between Glasgow and Dubai, for example, the necessity of bringing traffic through Heathrow is obviated. I do not see the right hon. Gentleman's difficulty with that. It is a policy that is supported—or perhaps it is not supported—by his colleagues in the Scottish Executive. Does the right hon. Gentleman have a different view? If he wishes to highlight that, I shall be pleased to hear it.
	I shall say a little about high speed rail and place on the record my disappointment with the conclusion reached by Sir Rod in that regard. In the report, he presents comparison between air and rail on emissions as a straight choice between the two. I see no evidence of that comparison taking account of the modal shift that could be achieved by freeing pathways for more freight on local train services. Equally, I see no convincing attempt to quantify the effect of taxing pollution by aircraft in the way that I mentioned earlier, and the impact that that could have in achieving modal shift.
	Sir Rod is right. Transport is crucial to the economic performance of the United Kingdom. That much is also a no-brainer. Congestion from any mode of transport costs British business dear every year. I had a meeting last week with representatives of the British Chambers of Commerce. They said that, overwhelmingly, transport was the main subject of concern to their members. That that should be so after nine and a half years of Labour government is a mark of the failure of Government policy. It is a mark of the challenge that faces us all. I sincerely hope that the Minister will be up to meeting that challenge.

Martin Salter: I do not often put in to speak in Opposition day debates, but I was particularly inspired to do so on this occasion,partly because of the staggering hypocrisy of the Conservatives over transport policy and partly because I wish to highlight several local issues to do with roads and railways in my constituency and in the Reading area.
	In my experience, the broader issue of transport strategy is an area full of pitfalls for politicians. Spending commitments on transport schemes tumble from our lips with consummate ease. That is enough to cause serious problems of credibility if one happens, as does the hon. Member for Epsom and Ewell (Chris Grayling), to represent a party committed to cutting tax and to cutting public expenditure. Let us not be in any doubt about that. At the last general election, just 18 months ago, the Tories were committed to making savage cuts in public expenditure. Their James review would have slashed £35 billion from local government, from the Department for Environment, Food and Rural Affairs, from Home Office programmes and, most significantly in the context of this debate, from transport budgets—the very same transport budgets that fund improvements to our road and rail networks to provide the increased capacity referred to in the motion before the House. If the Opposition are serious about having an honest debate on transport capacity, they should publish a full list, region by region, of the transport schemes that would face the axe had they been elected to form a Government on 5 May last year.
	Let us also be clear that the bright, new, clean, green, hoodie-hugging Tories are still committed to cutting back on Labour's investment in public services. The shadow Chancellor wants to take revenues generated by the proceeds of economic growth away from public investment in order to fund tax cuts. That means spending a minimum of £16 billion less—less money for roads, for buses, and for our railways. In fact, the shadow Transport Secretary is on record as saying that he is
	"not convinced the issue is about overall spending levels—there is a lot of money being spent today".
	Yet if we listen to the wish lists from the lips of Conservative Members, they say that not enough money is being spent on their constituents, but have no vision at all of how those revenues will be raised and how that investment will be put in place. Serious transport policy requires serious public investment. Of course there is a role for private investment, but it can never be a replacement for the funding of an affordable public transport strategy. After years of cutbacks and botched privatisations under the Tories, we are at last seeing the benefits of increased public investment under this Government. By next year, transport spending will be 60 per cent. higher in real terms than in 1997, when we came to office.
	The privatised railways that the Government, my party and the nation inherited gave us a fragmented network, the shambles of Railtrack, dreadful reliability, appalling rolling stock, a bad safety record, and profiteering and management buyouts.

Kelvin Hopkins: My hon. Friend might add to his list the horrendous costs in terms of track renewal and rail maintenance, which is between four and five times as expensive as it was in the days of British Rail.

Martin Salter: That is now on the record and I proudly add it to my list.
	I have no hesitation in stating that a measure of responsibility for the appalling Paddington train crash in 1999, which cost 31 lives, with many more injured, including some of my constituents, does not lie just at the door of Thames Trains. The finger of blames also points directly at those who privatised our railways and introduced a culture of greed, cuts in staff training and cuts in safety standards.
	The Tories are the last people to lecture anyone on rail policy. In fact, they have admitted as much themselves, as we have heard today with apologies for the privatisation of the railways. The shadow Transport Secretary has previously made it perfectly clear that the Conservatives have not had a clear transport policy, but only tactical positions. I will return shortly to tactical positions that they have adopted on transport issues.
	I want to talk about a transport vision for the Thames valley. I think that it is fair to say that I have always been prepared to work on a cross-party basis on issues where a consensus can be achieved. As such, I have been pleased to work with hon. Members from Berkshire and with Thames Valley Economic Partnership in drawing up a six-point plan for investment in the Thames valley transport infrastructure. That plan, entitled "Thames Valley—Sustaining our Success", was presented to Transport Ministers this morning by a delegation including representatives of major Thames Valley companies such as Dell, Oracle, Prudential, Siemens, Microsoft and Vodafone, together with the right hon. Member for Maidenhead (Mrs. May), my hon. Friend the Member for Slough (Fiona Mactaggart), and myself—but, sadly, not the hon. Member for Reading, East (Mr. Wilson), who has now left the Chamber. The plan states that
	"the thriving Thames Valley provides the thrust of Britain's economic success. Its businesses and the people who work here generate a larger slice of revenue for the government than anywhere outside central London. Europe's leading financial centre is dependent on support from the global companies based in the Thames Valley for the operation of their systems.
	A modern, well-ordered road system coupled with highly efficient public transport is also a pre-requisite for success. People need to be able to get to and from work quickly, safely, cheaply, and with a minimum of stress. Those buying or selling goods and services need to have access to fast, reliable transport. Since the Thames Valley is a location of choice as European or global headquarters for many businesses, travellers need to be able to make fast, seamless connections to London Heathrow Airport. Unfortunately the present infrastructure is failing the economy of the Thames Valley."
	I should like to put on the record my thanks to the Under-Secretary, my hon. Friend the Member for Lincoln (Gillian Merron), for the patient way in which she listened to that comprehensive presentation from members of all political parties and from some very powerful players in the Thames valley economy.
	The six priorities identified for investment, totalling between £1.5 billion and £2 billion, are as follows. First, and most importantly, there is the proposed Reading station upgrade to remove the bottlenecks on the Great Western main line. Secondly, there is the proposed AirTrack scheme, which BAA has announced that it intends to promote and which will provide rail access to Heathrow airport. Thirdly, there is the proposal for a direct link to Heathrow from the west via the Great Western main line. It is an utter disgrace that although we have the driving force of the Thames valley economy and companies that deliberately located there because of the proximity to the M4, to London and to Heathrow airport, we have no direct rail access to the major airport covering not only this capital but this country. Fourthly, there is the proposal to upgrade the north-south linkages in the Thames valley, particularly the M3 to M4 to M40 road connections. Fifthly, and more controversially, there is the proposal to widen the M4 on a phased basis—luckily not around Reading but around Slough and Maidenhead. Sixthly, there is the proposal to provide a Thames valley rapid transport system. All those schemes require significant public investment, and it is highly unlikely that any of them would see the light of day under a Conservative spending regime, past or present. However, as I said, I am pleased with the positive reception that the Minister gave us, even if she did not get her cheque book out this morning.
	I want to highlight the Conservatives' political positioning on three of those six schemes—political positioning to which they have already owned up. The first of the schemes is the upgrading of the north-south M4-M40 road connections. In Reading, that would mean the construction of the long-awaited third Thames bridge, a proposal that is promoted by Wokingham and Reading councils, but blocked by the Oxfordshire Tories. In fact, the Tory tactical positioning is so complex that the hon. Member for Henley (Mr. Johnson) will not even sit in the same room as the right hon. Members for Maidenhead, and for Wokingham (Mr. Redwood), and the hon. Member for Reading, East, and myself to discuss the third Thames bridge, which we all support, and which our constituents desperately need. There comes a point when seeking refuge in the argument of localism cuts no ice, because there are major strategic schemes that need to happen, and parish-pump politics cannot be allowed to get in the way.
	Secondly, I want to mention the scheme for rail access to Heathrow airport. That, at least, is an issue on which we can all agree, but it is far from clear how such rail access will be achieved. In my evidence to the Select Committee on the Crossrail Bill, I argued strongly for the inclusion of a western rail link to Heathrow. Although that is not part of the original Crossrail scheme, it will be an opportunity lost if we do not use Crossrail to resolve one of the major bugbears facing business travellers and commuters in the region. Figures presented to the Minister today by theThames Valley Economic Partnership show that the major companies in the region spend no less than£8.25 million a year on taxis to run customers and clients to London's Heathrow airport from places such as Vodafone's premises in Newbury, and Microsoft and Oracle's premises in Reading, all because we do not have proper rail access. Those cabs pour out carbon emissions and clog up the roads. I doubt whether Crossrail will ever provide the immediate solution that we seek, which is why I support the AirTrack proposals from BAA, and I encourage hon. Members to do likewise. That will deliver rail access from Reading via Bracknell, Wokingham and Staines.
	Finally, I turn to the upgrade of Reading station. Reading is the second busiest station outside London, providing direct train services to more than 360 towns and cities across Britain, as well as coach services to three of the four terminals at Heathrow airport. More than 20 million passengers use the station interchange each year, some of whom connect to it by one of more than 200 buses and coaches that serve it during peak hours. The station does not have enough platforms or track capacity to accommodate the frequency of services, especially at peak times. That is coupled with a busy junction at Reading West, which is heavily used by south-north freight services. The result is that passenger services are held up by congestion. That bottleneck affects the reliability of rail services across a vast region, from Paddington as far north as Birmingham, and from south Wales to the extreme south-west.
	A core scheme addressing some of the issues has already been developed. It would cost £68 million and could deliver substantial benefits to the region. The core scheme has been worked up by the Reading Station Partnership Board, which is led by Reading borough council and which comprises representatives from the Government office for the south-east, Network Rail, the South East England Development Agency, SERA and the Department for Transport. A formal bid was submitted in March this year. Ministers have acknowledged, in the House, the need to upgrade Reading station, for all the reasons that I have given. We await the final assessment of the Reading Station Partnership Board with some confidence and much hope.
	Unfortunately, that is the point at which consensus breaks down and good old Tory tactical positioning rears its ugly head again. There was an excellent degree of cross-party support for the Thames Valley Economic Partnership submission, but by stark contrast, the submission on the Reading station upgrade was the subject of silly party political games by the hon. Member for Reading, East, to whom I gave notice of the fact that I would refer to him in this debate. He has been utterly shameless in trying to claim credit for the hard work of others—so shameless, in fact, that his conduct is worthy of the Liberal Democrats. That should surprise no one; after all, he once stood for election as part of the Alliance between the Social Democratic party and the Liberals, before he discovered his undying allegiance to the Conservative party.
	Instead of working in partnership with Reading borough council and the members of the Reading Station Partnership Board, which was formed in 2001—well before the hon. Gentleman became an MP—he has tried to undermine the work of the board by seeking to set up his own stakeholder group, to which no other elected representatives in Reading are invited. He tries to drum up support for early-day motions that imply that the Government are blocking progress on Reading station, when in fact Ministers have been most encouraging and supportive. However, all his spin and blustering have been to no avail—he is well and truly rumbled. Only 11 MPs have signed early-day motion 2810, and the long-suffering stakeholders have recently asked him to operate on a cross-party basis and in a less partisan manner.
	Only last week, the hon. Gentleman pleaded with the Under-Secretary of State for Transport, my hon. Friend the Member for Glasgow, South (Mr. Harris), to grant his alternative Reading station partnership board a meeting in December. That meeting may take place next year, but the hon. Member for Reading, East will be overtaken by events, because it is with great pleasure that I can announce that the Secretary of State has kindly agreed to my request to meet the real Reading Station Partnership Board on 19 December to receive a full presentation of its excellent bid, which makes a powerful case for upgrading the capacity of Reading station, improving services on the Great Western main line and providing better facilities for passengers at Reading. The Tory transport hypocrisy continues. The hon. Member for Reading, East plays his pathetic partisan games but, in the end, it will be a Labour Government who deliver the Reading station upgrade and, hopefully, many more transport schemes that are badly needed in the Thames valley.

Peter Atkinson: The hon. Member for Reading, West (Martin Salter) is a Jekyll and Hyde character. He began with a 10-minute rant against the Tory party, before changing tack and providing a shopping list of six major schemes in the Thames valley that he wants the Government to fund. He finished with another rant, making an intemperate attack on my hon. Friend the Member for Reading, East (Mr. Wilson). His speech was as disappointing as the speech given by the Secretary of State—I am glad that the right hon. Gentleman is here, incidentally, so at least I can be rude to his face.
	It was deeply disappointing that, only a few days after the report by Sir Rod Eddington was published, the Secretary of State had so little to say about it. He was more interested in scoring petty party political points, rather as one would do in a school debating society, which is a great pity, because there is a great deal of cross-party compliance on the issues. We all know the problems of the transport system, including congestion on the roads and railways, and the subject deserves a more mature and sensible approach than it received from him tonight.

Alistair Carmichael: May I remind the hon. Gentleman that the hon. Member for Reading, West (Martin Salter) at least has the virtue of consistency? He has a long pedigree of profound dislike for the Member representing Reading, East, whoever they happento be.

Peter Atkinson: I agree. The hon. Member for Reading, West is a curious combination. He is an enthusiastic angler who likes catching fish, but he voted to ban hunting, which is a difficult piece of moral gymnastics.

Martin Salter: It is amazing that the hon. Gentleman should eat into his time to discuss angling and hunting. I do not know of any angler who would catch a prize specimen fish, throw it to a pack of dogs, watch it being ripped to pieces before smearing the blood on their forehead and calling it a sport. Anglers are not like that.

Peter Atkinson: With respect to the Chair, who may not wish us to continue to debate the subject, may I tell the hon. Gentleman that I, too, am a keen fisherman, but I support hunting?
	It is a pity that the Secretary of State did not deal more fully with the Eddington report, which is an indictment of Government inaction over the past nine and a half years. It applies just as much to 2000 as to 2007, because it identifies critical problems that were in evidence then and that have resulted in seven years of virtual inactivity by the Government. It contains much that is good, but it also has some serious flaws. My hon. Friend the Member for Epsom and Ewell (Chris Grayling), for example, pointed out that Sir Rod detracted from the abilities of locally elected democracies to determine big transport infrastructure problems. Today's report by Kate Barker seeks to establish an independent planning commission to take over from local government the role of dealing with large infrastructure problems, which is regrettable.
	I hope that when my hon. Friends write their manifestos on transport and other issues, they will sweep away the regional structure set up by the Deputy Prime Minister, including regional spatial strategy, regional transport planning boards and, of course,the grand panjandrum of the regional assemblies. If they went along with the independent planning commission, it would do a great deal to damage local democracy. Large-scale transport infrastructure planning in localised and regional areas should be undertaken by a combination of locally elected councillors, who, knowing the circumstances better, are better able to take those decisions.
	I agree with certain points raised by the Eddington report. In his well titled report, "The Case for Action"—the Government should have taken note of that—under the heading of "Key economic challenge", he says that
	"the Government should prioritise action on those parts of the system where the networks are critical in supporting economic growth and there are clear signals that those networks are not performing."
	There could be no better local example of an under-performing key route than the A1 Newcastle western bypass—the busiest stretch of dual carriageway in the entire UK. It is jammed in the morning, jammed at the weekends when people go shopping at the Metro centre, one of the largest in Europe, and jammed again in the rush hour at night. That road is causing a serious economic drag on the north-east of England.
	Car ownership is increasing faster in the north-east than in any other region—admittedly from a low base— but there are no plans to improve the A1. A few months ago, a plan was promised to try to manage the traffic better and increase capacity. I understand that the report was promised for about this time, but I am now told that it will not be published until winter 2007. Meanwhile, the economic problems get worse.
	This is not just a matter, incidentally, of Christmas special pleading in the manner of the hon. Member for Reading, West. It is a much more serious matter. What has happened in the north-east is the result of the road structures of the A1 and the A19. Proposed new industrial and commercial developments have been frozen by the Highways Agency's serving what are called article 14 orders on the development plan. Those orders effectively put a stop to development for up to six months and can then be renewed.
	I know that the Minister of State is aware ofthe particular problem with article 14 orders and the damage that they have caused to the economy of the north-east. I am pleased to say that most of them have now been lifted, but the abiding legacy of the threat of article 14 orders is that quite a lot of developers who would have developed regional projects have been frightened off. To delay a development for six, 12 or in some cases 18 months—as has happened—means that a developer incurs losses of many millions of pounds, particularly on large developments. They do not want to take that risk, which means we have lost the opportunity to create a large number of new jobs in the region.
	The deadening impact of those orders and of the poor infrastructure relating to the two crucial routes in the north-east has been the subject of an excellent campaign by the North East chamber of commerce, well supported by the local media, particularly  The Journal and the  Evening Chronicle. The campaign is called "Go for Jobs" and I know that the Minister is aware of it. Last month, it won the North East chamber of commerce an award for being the best campaigning chamber.
	Sir Rod Eddington specifies the importance of good transport links in the growing economy of a region such as the north-east. As he states in recommendation 10, to which I hope the Government will pay attention:
	"Government should focus on these areas"—
	he is talking about the inter-urban corridors and congested urban areas—
	"because they are heavily used, of growing economic importance, and showing signs of congestion and unreliability—and these problems are set to get significantly worse."
	That illustrates precisely the problem facing the north-east because of the failure to invest in new and crucial road systems. So I ask the Minister, please may we have some grown-up, joined-up government when dealing with transport in the region?
	The region's budget for transport has been settled at £457 million for the next 10 years. That is a trivial amount for a region where there is a shortage of decent transport infrastructure. If we compare that with Scotland, just across the border—I am sorry that the Secretary of State is not here—it is interesting to note that £3.5 billion has been allocated for transport infrastructure there in the next decade. I admit that the country has a population of about three times the size of that of the north-east, but one can see how disproportionate spending in Scotland is compared with that in the north-east of England.
	I add my support to a high-speed link between London and the north and Scotland. It is wrong ofSir Ron to dismiss it so simplistically—it is capable of improving the economy and we should support it.

Kitty Ussher: I am delighted to follow the hon. Member for Hexham (Mr. Atkinson). I am intrigued about whether he takes the train back to his constituency—I am sure that he does and I presume that my hon. Friend the Member for Reading, West (Martin Salter) does, too. If the hon. Member for Orkney and Shetland (Mr. Carmichael) wishes to intervene to clarify whether he takes the train back every week, I should be delighted to let him.

Alistair Carmichael: It is a matter of public record that there are no train services in Orkney or Shetland. I fly and I challenge the hon. Lady to explain a better way of travelling while doing the job of Member of Parliament.

Kitty Ussher: I am sure that Liberal Democrat proposals for that will prove interesting.
	Each hon. Member probably has a travelling tale to tell since such a large part of the job involves being in two places at once. I can speak only from my experiences but I think that the story is telling. My predecessor, Peter Pike, who was a Member of Parliament during the years when the Conservative party was in power, often flew between London and Manchester because the trains were so unreliable. Thanks to the recent improvements to the west coast main line under the Government—I am delightedthat the Conservative party acknowledges the improvements, although it opposed the funding for them—it is now far more time efficient to take the train. I travel to Manchester or Stockport in around two hours, which is fantastic. From there, it is less than an hour's drive to the constituency.
	That was a simple example with which to begin my contribution, but it proves the point. When, as consumers, we are faced with several options, we choose the easiest one. Thanks to the improvements to the railways under the Government, the easiest is often to travel by train. Our constituents are doing that, so I do not recognise the picture that Conservative Members paint.
	Let me present some facts that I do recognise. Investment in Britain's transport infrastructure will be 60 per cent. higher next year than it was 10 years ago. It needs more investment in the future, which we are providing, yet Conservative Members were unable to say this evening whether they would prioritise that investment over tax cuts. That was revealing.
	The Tories botched privatisation and starved the railways of the investment that they needed. They brought the railways to their knees; we have brought them the stability from which they can grow. Forty per cent. of trains have been replaced in the past five years; passenger numbers are growing at the fastest rate since the 1960s; passengers miles are growing at the fastest rate since the 1940s; and rail freight has increased by40 per cent. since 1997.
	When the Conservative party was in charge, Railtrack was laying as little as 250 miles of track a year. In 2003-04, Labour's replacement for Railtrack, Network Rail, was laying well over three times that, replacing 870 miles of track that year. That leads to this evening's all important question: why is the Conservative party implying that the improvements are long overdue when the work is being done and we have a sustained strategy for them? I can conclude only that it is up to its old tricks. In the words, which areworth repeating, of the Conservative Transport spokesperson, the hon. Member for Epsom and Ewell (Chris Grayling) about his party,
	"we've not had a clear transport strategy...we've had tactical positions".
	Tonight's debate is about another tactical position adopted by the Opposition. The country is getting used to this, and it is responding by asking, "Where isthe policy?" The answer is that the policy is all overthe place. The right hon. Member for Witney (Mr. Cameron) said a year ago that Britain needed a concerted programme of road building, yet the chair of his policy commission on quality of life—that title amuses me all by itself—has said that there is no doubt that there must be an assumption against road building. The only thing that I am left in no doubt about is that the only way to get a coherent policy on railways is to stick to the one that we have.
	That is not to say that action does not need to be taken, but let us be clear about what is going on. We have economic growth, better trains, and greater reliability leading to trains becoming more popular. That creates more demand, which is creating the greater need for investment. I agree with the Conservatives when they say that if they were in power, we would not be in this situation. When they were in power, we did not have the sustained economic growth, quarter on quarter, year on year, that we have seen for the past 10 years. Nor did we get the necessary investment in the trains or the track. So it is no wonder that people did not want to travel on the railways. Does that count as success, in the Conservatives' book? The overcrowding on some parts of the railway network, which we are addressing, is a symptom of our success. The question for the public out there is whether they would rather have a party that is committed to the long-term sustainable future of the network or one that is unable to say whether rail investment ranks as more or less important than tax cuts for the well-off.
	I shall give the House a local example. Manchester is experiencing a renaissance; it is booming. Obviously, the combined effect of a Labour council and a Labour Government has worked well. Of course, there are good jobs to be had, and my constituents up the road in east Lancashire want to have them. So the trains and buses into Manchester from my part of the world are crowded. The Conservatives try to make political capital out of this symptom of our success. Would they prefer it if there were no opportunities in our great northern cities that people wanted to travel to take advantage of? Sometimes that seems to be the case.
	Yes, success has led to issues that need addressing, and they are being addressed as part of the routine policy of this Government. In the north-west, it is timely that Network Rail is currently out to consultation on its rail utilisation study. As Members will know, this contains proposals as to where future passenger demand is likely to come from, and what changes will be required to the necessary infrastructure. Network Rail, created by this Government, is adapting to the challenges faced by the network over time. I welcome this study, and also the opportunity to explain how it can be used to improve the job opportunities available to my constituents.
	Burnley is a mere 30 miles from Manchester, but there is no direct train line between them. My constituents either get the bus—which offers a decent service, but is not always reliable at peak rush hour times—or they have to change trains at Blackburn or Hebden Bridge or, I am sorry to say, they give up their jobs in the city. I do not think that people should have to choose between their careers and their communities in that way—

Charles Walker: That is Labour.

Kitty Ussher: There was not a direct line when the Conservatives were in power either. It is nonsense that there is no direct train from Manchester to my constituency—

Charles Walker: That is Labour.

Mr. Deputy Speaker: Order.

Kitty Ussher: Thank you, Mr. Deputy Speaker.
	I hope that Network Rail will use the opportunity of the rail utilisation study to correct this anomaly, particularly as I am told by Northern Rail, which holds the franchise in my area, that the projections of passenger numbers into the next decade that form part of the report have already been surpassed due to high economic growth in the region.
	There are various ways in which a direct line could be established. One would be to have a direct train via Blackburn, which could be done fairly easily. However, establishing a regular service would require serious investment to upgrade the heavily congested single track between Blackburn and Manchester. Or we could go round the other side of the hill and reinstate a few metres of track known as the Todmorden curve, which would allow a direct train service between Burnley and Manchester using a bit of the Calder line. Either would do, and both would be supported not only by my constituency but by the neighbouring constituencies, which would also reap economic benefits. We must remember that investing in transport infrastructure is necessary not only to relieve bottlenecks, but as a tool for regeneration. People often get bogged down in the terminology of travel-to-work areas without realising that, by investing in the right infrastructure, we can enable those geographical areas to change quite substantially.
	The industrial revolution, which took place a long time ago in my part of the world, is a case in point. People often presume that the canals that criss-cross my constituency were built to take the textiles to market. In fact, it was the other way round. It was because of the existence of the Leeds-Liverpool canal, which was originally built to transport more basic commodities, that the cotton mills were built in Burnley. The same is true today: better rail links into the booming cities are a tool to regenerate towns such as mine. They will enable my constituents to commute to higher-paid jobs and make it easier for city folk to come and relax in a bit of Pennine Lancashire. The links between economic and transport policy need to be made more explicit. I am hopeful that the Government's response to the Eddington report will accept that.
	I welcome the increased investment in our railways under the Government. I welcome the greater prosperity and opportunity that economic stability has brought. I believe that the public do, too, and are voting with their feet and choosing to travel by train. That leads to capacity issues, which we are sorting out. As part of that, I hope that my plea for better transport links between my constituency and Manchester in particular will be heard. As this is an Opposition day debate, my question to the Conservative party is simple: is it simply positioning itself once more, or will it put its so-called commitment to the railways above its commitment to cut taxes for the better-off?

Christopher Fraser: I welcome this Opposition day debate, as it is on an important subject close to the heart of many people who live in Norfolk.
	I have raised with the Minister on many occasions the urgent need for the Government to address the roads infrastructure in Norfolk, particularly the A11, which is one of the most important links between the county and the rest of the United Kingdom. In particular, he knows that an eight-mile stretch of single carriageway remains between Thetford and the Fiveways corner roundabout, which leaves Norfolk as the only county, and Norwich as the largest settlement, not connected to the national, dual carriageway trunk road network. The road cannot cope with the existing weight of traffic, let alone that which the proposed 72,000 new homes in the county, and the welcome regeneration of Thetford, will bring.
	Norfolk county council has provided me with a copy of the East of England Development Agency's policy document for economic growth in the county. It is optimistically entitled, "Norfolk on the Move". I tell the Minister that Norfolk's drivers know that they are likely to grind to a halt through the sheer weight of traffic on the county's roads. The problems of the A11 are stifling the economy of the area. The business community, utterly frustrated by unfulfilled promises and ever-growing delays on that stretch of road, has rolled in behind our local authorities. A compelling case was submitted to the regional assembly. The scheme is, at least for now, scheduled for the second regional funding allocation funding period starting in 2010.
	The Minister has acknowledged, however, in an interview with the  Eastern Daily Press, that the operation of the regional allocation arrangements is problematic, and leads to mistakes and skewed priorities. He identified the "whale in the pond" syndrome, which tends to de-prioritise very large schemes that eat up a substantial proportion of a region's funding. He also acknowledged that areas on the geographical edge of a region could be overlooked in the decision-making process. To my constituents in South-West Norfolk, and to those in the surrounding area, it seems that they are constantly overlooked in the decision-making process. If evidence were needed, they cite the number of times that the dualling project has been promised and then delayed. Will the Minister accept that what he has called a "good and popular scheme" has suffered from both those factors? Will he seek to re-designate it as being of national importance, just as economic development in Norfolk should be of national importance?
	Will the Minister take this opportunity to confirm that the Government will take responsibility for the scheme, and dispel the concern in Norfolk that it may yet be put on the back burner, leaving us isolated and frustrated by a roads infrastructure that is not fit for purpose? Will he also acknowledge his support for the dualling of the A11 and join me in calling on the Secretary of State for Transport to approve it, so that a timetable can be drawn up and work can start immediately?
	At Attleborough in my constituency, there is yet another example of the Government washing their hands of the A11. Thankfully, that stretch of the road is about to be dualled. However, the Government have turned down a simple scheme to upgrade the nearest junction on the A11 at Besthorpe, which would route traffic away from an ever-congested Attleborough town. If carried out at the same time as dualling work, the project would have offered an economical and simple solution.
	The Government have refused an application for funding under the demonstration scheme, passing the scheme back to the county council, which does not have the funds to finance it. It will have to be carried out as a separate and therefore more expensive project, offering poor value to the taxpayer and yet more years of misery for the local community. Yet again, the Government's transport strategy fails to recognise the need for sensible investment in our roads, and best value for the taxpayer once again goes out the window.
	In a debate last November, I raised concerns about the state of the A47 in Norfolk and called for it to be dualled as well. The road is, in many places, unsafe and unfit for the weight of traffic that it carries. Accidents are frequent and often serious, and can have a catastrophic impact on travel across the area. It is one of the most dangerous routes in the country, yet improvements on the A47 are also considered of regional, not national importance. I say again to the Minister that the responsibility lies with the Government.
	The Minister has told me that his Department is not revisiting the method of defining road projects, but is reviewing how it works in practice. He has made time to visit Norfolk before, and I ask him to make time to come up again. Then he will see for himself how the regional allocation method works in practice and how Norfolk faces ever increasing difficulties while the method remains in place.

Si�n James: I am grateful for the opportunity to contribute to the debate. We should highlight the Government's commitment to rail transport. More rail journeys are being undertaken in Britain than at any time since the 1940s. Rail freight is up by 46 per cent. since 1997. More trains in England and Wales arrive on time compared with 2001, mainly as a result of the increased investment after many years of neglect under the Conservative Government. I have worked in the rail industry and know from first-hand experience about the challenges of clearing up the mess left by that Government. The need to push forward an integrated transport agenda has been key within the industry.
	Unfortunately, the performance of First Great Westernthe mainline operator to my constituencyhas not been so effective or matched the Government's commitment to improve rail transport. It has been named as one of the worst performing franchises in Britain, with a 79.4 per cent. reliability record. It has also recently announced changes to services to Swansea, which has caused great concern to my constituents. In particular, they are worried about the termination of the 15.15 London Paddington to Swansea service at Cardiff. The changes will have a serious effect on Swansea's status as a mainline station on an important inter-city route. The proposals are a retrograde step and are being interpreted locally as downgrading the second city of Wales. Swansea is an important rail city and a key business and tourism destination; it is also the gateway to west Wales. The proposals appear to make passengers from Swansea and west Wales less important than those in other parts of the country.

Julie Morgan: I support my hon. Friend's remarks about First Great Western. If the service beyond Cardiff is going to stop, the service to Cardiff may soon stop as well. It shows a lack of interest in Wales on the part of First Great Western. Is she aware of the proposal to cut the buffet service between Cardiff and Paddington, about which I have received a complaint? Does she think that that is a strange way of improving the rail service?

Si�n James: I certainly do. It highlights the factthat a company that was recently engaged in a refranchising process, when it made many promises, is now making cuts at will and making changes that suit it, not the people that it is supposed to be serving.
	The passenger flows between Swansea and Cardiff are vital to a number of local communities and businesses, and for economic development. Not everyone needs or has to travel to London on a regular basis. The daily commuter journeys between Swansea, stations along the south Wales main line and Cardiff are equally important. The commitment of First Great Western to those services is essential. As I said, it actively pursued the franchise and I am disappointed that the fine words and promises contained in its bid now appear to be nothing more than window dressing. It has ignored all representations about the 15.15 service. I believe that that service is being killed off by First Great Western's failure to consult properly. The consultation period has been little more than a sham. There has been a poor response from First Great Western, which has refused to publish any submissions and has not made its decisions public before the point of implementation, thus in effect allowing no appeal.
	Following closely on the heels of the refranchise bid, there has been much confusion. It is understandable that the public, who believed that the franchise proposals submitted by First Great Western would be in place for a credible period, have been left feeling confused and let down by yet more inadequate consultation.
	The company apparently has no interest in serving evening commuters. Between 5 am and 8.30 am, there is a half-hourly service between Swansea and London. Eight trains, each carrying up to 360 seated passengers, travel the Swansea-to-Paddington route. During that period Arriva Trains Wales runs two services which can carry a combined total of 300. Several thousand are carried by First Great Western; a few hundred are carried by Arriva Trains Wales. But how do those people make their return journey in the evening? First Great Western is happy to take their business in the morning, but feels no responsibility for getting them home at night. What kind of strategy and what kind of franchise commitment is that?
	Poor Arriva Trains Wales will now be expected to fill the gap left by the removal of the 15.15 from the timetable. Commuters anxious to get home after a hard day's work will have to try to obtain seats on an already popular service. It is the proverbial attempt to fit a pint into a half-pint pot, and can only mean more inconvenience and discomfort for the loyal passengers whom First Great Western are happily abandoning. I fear that many will switch to their cars and that we will see more congestion and pollutionproblems that we should be working to decrease, not increase.
	I urge my hon. Friend the Minister to do his utmost to ensure that the people of Swansea and west Wales continue to benefit from increased investment, reliable trains and improving services.

Maria Miller: It is a pleasure to follow the hon. Member for Swansea, East (Mrs. James). I know her area well. It seems that we share the problem of overcrowded trains, although our constituencies are many miles apart. I am pleased to see that the hon. Member for Burnley (Kitty Ussher) is still present. I was interested by her speech, in which she said that she did not recognise the situation described earlier by many of my hon. Friends. I hope that I shall be able to give her some more specific examples of problems that my constituents face daily.
	In my constituency, as well as those of many other Members, a huge expansion in house building is taking place. About 800 houses a year are being built in Basingstoke, butI fearwithout the investment in infrastructure that would enable more people to settle in our part of Hampshire without any negative effect on the current population. Transport links are a particularly good example of the problems of investment in infrastructure, but there are many other examples, including essential utilities and services. Energy, water supply and other important elements of infrastructure are not being planned well enough, or receiving enough investment, to match the level of house building required by the Government.
	Last week saw the publication of the Eddington report, to which many Members have referred today. It is the latest in a long line of transport documents published since 1997. Sir Rod Eddington made three important points. He called on the Government to focus policy and sustained investment on improving the performance of existing transport networks in those places that are important to the UK's economic success.
	He went on to say:
	Government, together with the private sector, should deliver sustained and targeted infrastructure investment in those schemes which deliver high returns.
	He emphasised that
	the policy process needs to be rigorous and systematic.
	Those are fine-sounding words, but this is the eighth major document on transport from the Government in nine years. There have been two White Papers, a 10-year plan, and now the Eddington report.

Charles Walker: Given that this is the eighth such document in nine years, is my hon. Friend confident that its recommendations will be carried through, or does she think that it is just more time-filling by a Government who are very short of ideas about what to do to ease current problems?

Maria Miller: I thank my hon. Friend for that intervention, but he is, I think, being rather fair-minded to the Government by suggesting that that is their intention. My Basingstoke constituents might have a slightly different spin on that when they look at the amount of house building that is required in north Hampshire and then look at the dearth of funding that follows that centrally driven Government target. The amount of reports, White Papers and documentation that has been produced on the sector under discussion seems to mask a confusion, inconsistency and short-sightedness in transport planning; that is certainly the case in my area of the country.
	My constituency of Basingstoke is just the sort of place that Eddington highlighted in his report as requiring a focused policy of investment in transport. It is home to 69,000 jobs. It has one of the largest concentrations of employment in the entire south-east of England, and it is therefore an integral part of the future of this country. The Government have called it one of their diamonds for growth; others have called it part of the string of pearls. They are fine words, but fine words cannot mask the disconnect between house building targets and the lack of investment in infrastructure. The Government need places like Basingstoke to generate the wealth to fund their spending plans, so they need to be prepared to invest in areas such as Basingstoke to ensure that its success is sustainable in the future.
	We cannot have commuters spending hours in traffic jams on the M3 motorway. There has also recently been a significant increase in the number of accidents on our section of the motorway, some of which, tragically, have resulted in fatalities. We in north Hampshire have not had sufficient investment, particularly in our motorways and roads.
	There are other local examples of lack of investment. There is a major business park in my constituency: the Chineham business park is a highly successful area of economic activity, and it is home to many blue-chip companies and major names that Members will be aware of. A part of the plans for that business park was to build a railway stationMinisters might be aware of thatbut since those plans were put forward there has been a complete lack of funding, which means that it has not been possible to deliver that railway station. The result of that is being borne by my constituents, who are now having to deal with major problems to do with traffic cutting through residential areas, because people do not have the option of travelling to their place of work by train rather than car.
	Local employers tell me that there are two reasons why they want to locate in Basingstoke. In some cases it is their first choice to locate, rather than Reading, because of the congestion problems in that town that the hon. Member for Reading, West (Martin Salter) highlighted. They choose Basingstoke because they have access to well qualified and highly experienced staff, but also because of accessibility. I am concerned that the large-scale house building projects that are being foisted on the local councilwith very little ability to resist themcombined with lack of investment in transport will simply be no good at all for residents or business.
	There are many estimates of how much money is required to fill the yawning infrastructure gap that there is not only in Basingstoke but throughout what is now designated by the South East England Development Agency as a western corridor area. Hampshire county council has told the South East England regional assembly that investment of some 4.5 billion is needed to improve transport infrastructure in the western corridor and Blackwater valley growth area, which, as the hon. Member for Reading, West said, is one of the most important areas of economic development in the country. In my bit of that areaBasingstokewe need no less than a250 million investment in transport alone to fill the gap created by the lack of investment in recent years.
	I ran off a list of the projects that the western corridor and Blackwater valley area needs in terms of investment in infrastructurethe document has been submitted to the Governmentand no fewer than 10 of the 34 projects on that list directly relate to my constituency. I hope that the Minister will take the opportunity when he responds to give me some thoughts on how he will help Hampshire county council and SEEDA to plug some of those gaps. The Government are happy to set targets, but they are not prepared to ensure that the plans are in place to enable such targets to be properly thought through. That is a million miles away from the integrated transport policy that they originally promised us; nearly 10 years on from their taking office, we are still waiting.
	I want to consider a couple of other examples of how the transport infrastructure gap in my constituency is not just opening up but increasing in magnitude. We have already heard a great deal about the train networks in various parts of the country. I will not dwell on that issue, except to say that my constituents not only have to endure overcrowded trains, they often have to spend an hour travelling into London, unable to sit down for the entire journeyor for the journey back. The train operator promised increases in capacity, but that has yet to become a reality. I welcome the fact that my Front-Bench colleagues have given a commitment to regarding that as an urgent problem as we develop our policies.
	There are other pressing issues in my constituency relating to the M3 motorway, which runs directly through its centre. It is an important access route and an important part of why Basingstoke is the success that it is, but a tremendous increase in traffic on that route has not been matched by investment in measures to alleviate the problems associated with congestion and noise. I have recently tabled a number of parliamentary questions on this issue because of an increase in the number of letters that I receive from constituents on it. Government calculations indicate that the level of traffic noise on the M3 between junctions 5 and 7 has increased by about 4.5 dB in the past 20 years. To many a lay person, that might not sound like an enormous increase, but I remind Members that the decibel is a logarithmic unit, and that a 3 dB increase, as the Minister doubtless knows, equates to a doubling in sound level. If Members were to stand by the side of the M3 in Mapledurwell, a beautiful village in my constituency that is completely unshielded from the motorway by any form of physical sound barrier, they would understand why many residents are deeply concerned at the fact that the increase in traffic has not been matched by the provision of sound-avoidance measures.
	We thought that we had come some way on this issue under the careful guidance of my predecessor, who obtained an assurance that a noise-retardant surface would be used on the section of the M3 that passes through the centre of my constituency. Indeed, we were very pleased with the outcome of the negotiations with the Government. Only last week, however, I heard that a very firm promise might be overturned; despite a promise to resurface the M3 completely with noise-retardant material only one lane is to be treated. That is a great disappointment to residents of the villages of Mapledurwell, Up Nateley, Nateley Scures and Old Basing, for whom that measure represented their only hope that the Government would try to alleviate a growing problem.
	The other result of increased traffic flow on the M3 that has not been coupled with a measure to try to alleviate the problem is congestion at junction 6, especially the Black Dam roundabout. All my constituents who use the M3 are very aware of that problem. The roundabout was built to accommodate a maximum peak flow of about 5,500 vehicles an hour, yet a survey last September found that it was already operating well above capacity, and the Government have no plans to try to improve the situation in the near future, despite significant amounts of house building.
	There is a pressing need to upgrade that key section of the motorway, yet when I asked the Minister of State what assessment had been made of the need to increase capacity, he merely replied:
	Agreement was reached in principle on the need to accommodate traffic resulting from the Local Plan...The Highways Agency will review the situation when the Local Plan...becomes clearer.[ Official Report, 11 November 2005; Vol. 439, c. 782W.]

John Leech: Can the hon. Lady explain how upgrading the motorway and other road networks will help to deal with the problem of noise generated by the motorway?

Maria Miller: The answer is simple. We need a more co-ordinated approach to dealing with increased traffic volume. At present, there are ad hoc measures in my constituency to try to shield the various communities that abut the motorway. Some of them are evenbeing given planning consent to build alongside the motorway, but there is no plan for a co-ordinated approach to noise abatement. Such plans need to be developed and I have already raised the issue with the Highways Agency.
	A final result of increased congestion on the motorway is greater use of another local roadthe A3which over the last 12 months has, tragically, come to be known as a black spot. It is used as a relief road by motorists wanting to avoid congestion on the M3 and there has been a significant increase in traffic, which has resulted in more accidents, and the county council has had to make considerable changes in the layout of the road network. It has not, however, got to grips with the fundamental problem, which requires significant investment.
	Amid all that procrastination, confusion and buck passing, my constituents are suffering, and I hope that Ministers will take that point very seriously indeed. The consequences of the lack of planning are borne by residents, and there is no better example than my constituents who live in the beautiful, historic village of Old Basing. The area has narrow lanes and few footpaths. At Old Basing infants school, which is beautiful and well respected, traffic volume is so high that even parents who live nearby are forced to use their cars to take their children to school.
	I could give many such examples from my constituency, but time is short so I will conclude my contribution to this important debate. My constituents do not want forests of policy papers and a maze of funding streams; they want the Government to understand that Basingstoke has a transport infrastructure gap. The Government cannot ignore the problem any longer. They cannot simply hand on housing targets without providing proper plans and proper funding for increased infrastructure. If they do not feel that they are well placed to develop such plans, they should leave it to local people, who understand what is needed for our community, to draw up the plans and see them to fruition.

Nia Griffith: I am certainly not one to dwell on the negative, but it has to be said that the appalling fragmentation of the rail services under the Tories has left us with a nightmare scenario in west Wales. Not only do we have track problems, which have to be sorted out by one company, and then other companies charging huge sums of money to the rail operators for relatively old rolling stock, but we have a complicated situation that involves using two rail companies to get from Llanelli to London. Yes, indeed: I have to travel with two companiesArriva and First Great Westernevery week.
	Unfortunately, as only 74 per cent. of the First Great Western trains arrive on time, that can lead to all sorts of difficulties in Swansea, where Arriva has to pick up the tab. When I travel home from Parliament on a Thursday evening, I quite often find myself travelling by bus or taxi as Arriva desperately tries to get passengers to their destinationsand, in particular, tries to get passengers who want to get the ferry to Ireland to Fishguard on time.

Paul Rowen: Will the hon. Gentlemanhon. Lady give way?

Nia Griffith: Yes.

Paul Rowen: Will the hon. Lady tell us what Ministers should be doing to sort out that appalling problem, given that they have had nine years to do so?

Nia Griffith: Absolutely. I am just about to come to that. We have already made a good start. The issue is that there has been such fragmentation that it is taking a long time to put all the bits back together again. We started with that disadvantage.  The Independent got it wrong yesterday and had me as Mr. and my age as 60, but, given that the hon. Gentleman is facing me, perhaps he could notice the difference.
	It is heartening to see how many people in west Wales use the trains now, but they deserve a much better deal than they are getting. Unfortunately, the huge charges that the ROSCOs are demanding for rolling stock mean that we are still short of carriages on some trains, with people standing for considerable distances. We have some spectacular views along the coast in my constituency, but coastal erosion is causing considerable concern west of Llanelli. Since privatisation, we have yet another company that is responsible for the track. With that Tory legacy of so many different companies, it is all too easy to shift the blame around and infinitely more difficult to improve the services.
	I endorse the comments made by my hon. Friend the Member for Swansea, East (Mrs. James) about the First Great Western service from Cardiff to Swansea that currently leaves at 17.18, but is threatened. The new timetable comes in on Monday. Only the week before last, when my hon. Friend and I went to see for ourselves what was happening on the 17.18 train from Cardiff, we saw that the preceding train was absolutely full and that the platform immediately filled up again with a new crowd of people. When we got on the 17.18 train it, too, was full. It just does not seem to make any commercial sense to remove that train, leaving a huge number of people to try to squash into the next train. It is a real exercise in alienating one's loyal customers. I urge the Minister to do whatever he can to influence First Great Western to retain that service.
	We also need to completely rethink our attitude to Sunday services. Our attitude to Sunday timetables assumes that no one wants to travel on Sunday, but, with increased leisure opportunities, many people would like to make greater use of the trains on Sundays for days out, weekends away, visiting friends and family, or getting to an airport to go on holiday. Current Sunday timetables make that difficult. The first train eastwards from Llanelli does not leave until after 11 o'clock in the morning, and we all know how crowded the few trains that run on a Sunday evening can be, as people try to come home from weekends away.
	Inevitably, all too often that means that people turn to their cars, with the subsequent environmental consequences. We need some enterprising thinking about providing a much better service and promoting the use of rail travel on Sundays. One excellent example of encouraging the use of the train for an enjoyable day out is the work done by the Heart of Wales Line Travellers Association, which recently celebrated its 25th birthday. Its excellent work in promoting day and weekend excursions is an example to all and we would like to see a lot more of that type of approach. People really do want to use the trains and we therefore need to continue to pull together the fragmented serviceand use a Government hands-on approach to ensure improvements in the provision.

Owen Paterson: We have had a most interesting debate. It is a pleasure to follow the hon. Member for Llanelli (Nia Griffith), who said that there are no direct links to her constituency. She should try getting to Shropshire, as I said to the Under-Secretary of State for Transport, the hon. Member for Glasgow, South (Mr. Harris), last week.
	Our debate began with a fine performance by my hon. Friend the Member for Epsom and Ewell (Chris Grayling), the shadow Secretary of State. We then heard a less scintillating performance by thegenuine Secretary of State, who failed to give the hon. Member for Birmingham, Edgbaston (Ms Stuart) a commitment on the Birmingham gateway. When he responded to an intervention made by my neighbour, my hon. Friend the Member for Shrewsbury and Atcham (Daniel Kawczynski), he completely failed to understand that he was talking about an open access agreement that required no public subsidy whatever.
	We heard a characteristically narcoleptic performance from the hon. Member for Orkney and Shetland (Mr. Carmichael), before we moved on to the hon. Member for Reading, West (Martin Salter), who gave us a glorious dinosaur attack on rail privatisation that wholly ignored Rod Eddington's praise for the private sector's vital involvement in transport. The hon. Gentleman also made an intemperate attack on my absent hon. Friend the Member for Reading, East (Mr. Wilson), which was picked up by my hon. Friend the Member for Hexham (Mr. Atkinson), who made a powerful case for transport decisions to be taken locally by elected councillors. He gave telling examples of the way in which poor infrastructure has held back economic growth.
	The hon. Member for Burnley (Kitty Ussher) began her speech with an amazing question. She asked the hon. Member for Orkney and Shetland whether he took the train back to his constituency. Perhaps the Government Whips Office should give the hon. Lady a map. For her information, Stavanger has the nearest railway station to the hon. Gentleman's constituencyperhaps he would be more interested in the location of airports. The hon. Lady then descended into a rant against rail privatisation. Labour Members must make up their minds about this: they cannot take credit for the 50 per cent. increase in passengersspectacular growthyet keep knocking privatisation.
	My hon. Friend the Member for South-West Norfolk (Mr. Fraser) certainly won the award for shirt of the debate. He put forward a powerful case for the duelling of the A11 and described small junction improvements that can have a disproportionatelylarge impact. Such improvements are exactly as recommended in Eddington. We then heard from the hon. Member for Swansea, East (Mrs. James), who made interesting comments about the difficulties regarding local rail services. She criticised the franchise and the consultation process. My hon. Friend the Member for Basingstoke (Mrs. Miller) made a clear and thorough speech in which she set out very clearly and well the grievous problems that are caused when there is increased house building without any increase in infrastructure capacity to match the huge demands for various modes of transport.
	My hon. Friend ended her speech by attacking the procrastination, confusion and buck passing of the Governmentbut, of course, that goes back a long way. The Labour party manifesto in 1997 promised to
	develop an integrated transport policy to fight congestion and pollution.
	However, there was no transport Bill in the new Labour Government's first Queen's Speech.
	On 6 June 1997, the Deputy Prime Minister said:
	I will have failed if in five years time there are not ... far fewer journeys by car. It's a tall order but I urge you to hold me to it.
	In October 1998, he said:
	I agree to keep to that commitment.
	That was confirmed again by the hon. Member for Hampstead and Highgate (Glenda Jackson), who, when asked,
	Will traffic be reduced in overall terms across the UK,
	said:
	Yes, because all local authorities ... will have to abide by the legislation that is in place which has to do with precisely that, the reduction of road traffic.
	When questioned by my right hon. Friend the Member for Wokingham (Mr. Redwood) in December 1999, the Deputy Prime Minister stuck to his guns and said:
	I said that there would be fewer car journeys.[ Official Report, 20 December 1999; Vol. 341, c. 532.]
	What happened? By June 2002, car traffic was up by7 per cent.
	In 1998, A new deal for transport: better for everyone was published. That White Paper promised an integrated transport policy and a shift in road investment from building new roads to maintaining and managing the existing road networks. It proposed to address the perceived fragmentation of rail by creating the Strategic Rail Authority to provide
	a unified vision and promote the interests of passengers and freight customers.
	So, what happened to the Strategic Rail Authority? The shadow authority was established in 1999 and the SRA itself was put on a formal legal basis by the Transport Act 2000. The authority ended its shadow existence in February 2001. However, after the Railways Act 2005 had been passed, the authority was wound up and its functions were transferred to the Department for Transport rail group. So much for the unified vision.
	Next, in December 1999, the Government launched a 10-year investment plan to improve Britain's transport systems. The plan, which was intended to provide a framework for large-scale capital investment in the UK's network, was to cost 8 billion to 2010. The Deputy Prime Minister said at that time:
	It will be a 10-year route map for a transport system fit for the next century, with milestones along the way.
	What did we have next but the 10-year plan launched two years later in July 2000. The Deputy Prime Ministerstill at itsaid that
	The plan will get Britain moving and give the people of this country a transport system on which they can rely.[ Official Report, 20 July 2000; Vol. 354, c. 552.]
	He promised 360 miles of strategic road network improvements to remove bottlenecks, 80 major trunk road schemes, 100 new bypasses, 130 other major local road improvement schemes, and completion of 40 road schemes in the Highways Agency targeted programme of improvements. On the railways, he promised a 50 per cent. increase in use measured by passenger kilometres, an 80 per cent. increase in rail freight, improvements in service quality, more punctual and reliable trains, and less overcrowding.

Anne Main: Will my hon. Friend join me in asking the Government to make a speedy funding decision on the Thameslink 2000 project, which has just got off the buffers of the planning process?

Owen Paterson: I am grateful to my hon. Friend for highlighting yet another broken promise. We have heard a catalogue of them throughout the debate.
	There is no question who is to blame. In June 2001, the right hon. Member for North Tyneside (Mr. Byers) took over as Secretary of State for Transport, Local Government and the Regions. On 15 January 2002, in an interview with  The Guardian, he saidI urge Ministers to listen to this:
	It's now our responsibility. There can be no more excuses, I want to draw a line in the sand. It's our responsibility. We can't blame the Tories any more.
	In the very same month, much to the chagrin of the new Secretary of State, the noble Lord Birt was brought in to advise No. 10 with blue-sky thinking on transport, but he angered the Transport Sub-Committee by refusing to appear before it to reveal his thinking. Meanwhile, the Select Committee on Transport, Local Government and the Regions published its assessment of the 10-year plana crushing assessment. The Committee said that the report was mistaken, wrong, ill balanced, incomprehensible and over-optimistic.
	On we went, and in May 2002 the right hon. Member for North Tyneside resigned, to be replaced by the right hon. Member for Edinburgh, South-West (Mr. Darling). In December, the new Secretary of State unveiled a new 5.5 billion package of transport improvements, but revealed that the Government had spectacularly miscalculated the amount of traffic in Britain's roads. He warned that motorists were likely to spend up to 20 per cent. more time in traffic jams by 2010 and admitted that the targets originally set by the Deputy Prime Minister would not be met. The Government thundered on with another White Paper, The Future of Transport, which was published in July 2004. It stated:
	We need a transport network that can meet the challenges of a growing economy and the increasing demand for travel,
	and the subsequent Labour party manifesto spoke of road pricing.
	The Government have failedthey have failed miserably. Let me cite three outside organisations in support of my case. The Confederation of British Industry has found that 86 per cent. of businesses regard UK road links as important, and 94 per cent. of those companies say that congestion is a problem. This afternoon, I met representatives of the Road Users Alliance, which says that congestion is costing business 15 billion to 20 billion a year. Tim Green, the alliance's director, said that
	Traffic has grown by 29 per cent. in the last 10 years and road capacity has increased by less than 2 per cent. The Government has totally underestimated the network that is required despite having taken 400 billion in taxes from road users but having spent only 7 billion per year on roads.
	In September 2006, the survey carried out by the British Chambers of Commerce, which represents 100,000 UK companies of all sizes, showed that 80 per cent. feel that there is a problem with road congestion that affects their business locally, regionally and nationally. The British Chambers of Commerce says that we are rapidly approaching Gridlock Britain unless a determined effort is made to improve our roads, removing pinch points and managing the network better to facilitate smooth flow and reliability of journey time.
	Now, we come to the Eddington report, which is400 pages long in the Vote Office, but covers more than 1,000 pages if one includes the annexes on the internet. There are elements of the report that we strongly support. We have consistently supported the disproportionate gains of small schemes. Paragraph 199 on page 38 of the smaller volume entitled Advice to Government points out that small junction improvements often cost below 20 million, but show wider benefit:cost ratios well in excess of 4 and some going up to between 8 and 10. That was a point picked up by my hon. Friend the Member for South-West Norfolk. Many smaller road and rail schemes have been supported by Members throughout the House. Will the Government clarify tonight whether it is their intention to reinstate those schemes before 2015?
	Eddington explores at length the difficulties of our current planning system and makes radical proposals to introduce an inquisitorial system and what would effectively be guillotines on time. There is an extraordinary graph showing that the inquiry on the M6 toll took 150 days, and the terminal 5 inquiry took several years and cost 60 million. These are significant delays and costs. Do the Government intend to pursue the proposal?
	At the centre of the report is road pricing. Eddington enthusiastically supports the creation of a national road pricing scheme, on the ground that if it were introduced it would reduce the need for infrastructure capacity increases. The Opposition are convinced that the travelling public will react to the price mechanism and change their behaviour. In order to manage demand effectively, the price must vary. We do not support simplistic congestion charge schemes. A good example of the benefits of a variable road pricing scheme is the one that I saw this summer on the SR91 in southern California.
	There is a road connecting Riverside, where many people live, and Orange county. The four lanes were jammed solid morning and evening. High occupancy vehicle lanes, which the Government are keen on, were added. Sadly, those were a waste of time. They were also jammed solid morning and evening. The four HOV lanes were converted to high occupancy toll lanes, with a varying toll. The number of vehicles doubled and the speed trebled.
	We are convinced that the public will tolerate road pricing if it is variable and if it delivers improved reliability. It is also vital that revenues are ploughed back into infrastructure to maintain public confidence. But it is a huge jump from that to a national scheme. We have serious concerns. It is one thing accepting the principle of price as a tool, but it is quite another thing to bank everything on establishing the first national road pricing scheme. We heard about the huge projects that have gone wrong in the Department of Health and the Ministry of Defence.
	The Driver and Vehicle Licensing Agency database holds records of 36 million vehicles and 47 million drivers, of which 68 per cent. are correct in every detail, but 10 per cent. are not. I do not underestimate the task for the DVLA, but when do the Government think there will be a watertight database? There are serious civil liberties issues involved. When TollCollect set up its scheme in Germany, the diffusion of information to any Government Department was banned.
	European directive 2004/52 deals with the interoperability of electronic toll collection systems. The crucial issue is the European electronic tolling service, which is intended to allow vehicle operators to subscribe to access any electronic charging scheme in Europe. The technology is immature. It is intimately connected to the progress of the EU's Galileo GNSS. As it was originally anticipated that EETS would not come into force for cars until 2012 and the system is already subject to delay on that timetable, do the Government consider that the regulatory and technical framework will be in place to meet the 2015 timetable?
	To summarise, the Government came to office almost 10 years ago with simplistic and dogmatic ideas that the travelling public could be forced off the roads and on to public transport. They totally underestimated the growth in traffic demand for both road and rail. They have not increased capacity to keep up with demand and have failed to achieve their targets, letting down the travelling public in a spectacular manner. Under a succession of incompetent Ministers, the Department for Transport has been excessively timid and cautious. That is compounded by the fact that we are now Waiting for Gordot. We know that the Chancellor is floundering in his search for tax revenues, and my fear is that the Treasury, which was the chief sponsor of the Eddington report, sees road pricing as a future gold mine. The Chancellor already has his man in the Department for Transport, for the Secretary of State is effectively a sleeper waiting to be woken by the great clunking fist.
	On page 175 of the main report, Eddington specifically warns of the dangers of delay. He points out that
	pricing of this scale is not to be found anywhere else in the world
	and that
	there is currently insufficient evidence to be able to identify what the 'right' option should be.
	He says:
	This uncertainty is not an excuse for doing nothing. Indeed, one of the most serious risks is that government and the private sector scale down their plans for investment on the basis that pricing will reduce the need for additional capacity, but for road pricing not to be delivered. This could result in a severe shortage of transport capacity, resulting in worsening congestion for road users and billions of pounds of cost to the economy.
	We fear that the Government will use Eddington as a shieldan excuse for another nine years of inactivity and tax increases that will be catastrophic for Britain's travelling public. Conservative Members remember that in Samuel Beckett's play the protagonist never arrived. We understand the needs of the travelling public, we understand the misery that the Government are putting them through, we understand what needs to be done, and I urge the House to support our motion.

Stephen Ladyman: The hon. Member for North Shropshire (Mr. Paterson) said that it would be catastrophic if we delayed any further, yet he refuses to commit to a single transport project. The document that the Conservatives have just produced detailing their plans for transport says, in effect: We commit to nothing. We promise nothing. Yet they have the cheek to give us a shopping list of schemes that they wish to imply will be built, having committed to nothing.
	On rail, the hon. Member for Epsom and Ewell (Chris Grayling) completely overlooked the facts. This Government have invested 8 billion in the west coast main line. We have delivered 44 per cent. more train services on the east coast main line. We have overseen a rise of up to 1 billion passenger journeys a year. We have presided over the fastest growing railway in Europethe railway with the youngest rolling stock fleet in Europe. We have achieved 90 per cent. reliability. We have opened the first phase of the channel tunnel rail link, with the second phase soon to be opened. We have seen a 46 per cent. increase in railway freight since 1997. We have delivered train protection warning systems on the whole network. We have even seen Network Rail delivering a profita profit that goes not into the pockets of the City, but back into railway investment. That is what this Government have deliveredyet the Conservatives, who delivered us Railtrack and privatisation, made the channel tunnel rail link a basket case that we had to rescue, and introduced rail policies that led directly to tragedy and the disaster at Paddington have the cheek to criticise us.
	On buses, we now have 2 billion-worth of funding invested in bus services; 400 bus projects supported by the bus challenge competitions; rural bus subsidy grants supporting more than 2,200 rural services, with more than 29 million annual journeys made on them; bus and light railway use up by 8.1 per cent. since 2000-01; 50 per cent. of the bus fleet now accessible to people with disabilities; and some 11 million older and disabled people due to get concessionary fares. All that from this Government, while the Conservatives, who delivered us deregulation, dare to criticise us.
	On roads, we have 39 major trunk roads and motorways completed, with 17 under construction; the M25 being widened to four lanes; active traffic management being delivered to make the best use of the network; regional control centres being built to keep the traffic moving; 1,000 highway officers; real-time traffic information delivered to motorists; road fatalities down; road injuries down; and vehicle excise duty evasion down. All this, and the Conservatives, who gave us the cones hotline, dare to criticise us.
	Did Conservative Members mention that otherkey transport modalityshipsin their motion? Nostrangely, ships have not even been mentioned, despite the fact that the shadow Minister concerned has been sat on the Front Bench for most of the debate. That is hardly surprising, as it is Conservative party that destroyed British shipping and left us without it. The Government have quadrupled the number of ships under the red ensign. Under the Government, the amount of shipping has risen, providing 10 billion in net earnings. Shipping is now the third biggest export earner in the country's economy, thanks to the Government, yet the party that destroyed the red ensign and left the British fleet flagged-out dares to criticise us.
	The shadow Secretary of State says that he wants action, but he will not put his name to anything. His big plan on aviation, according to a document published just a few days ago, is as follows:
	We are studying the different issues carefully and intend to make full use of the time available to us in Opposition to address these issues.
	As he told us just today, his big plan on buses is to wait and see what the Government propose. What is his big plan on trains? That is a good question, because the document hardly mentions trains, except to give the revelation that
	Rail, for example, is essential to carrying commuters into...cities.
	Well, we needed a Conservative think-tank to give us that information. As for his big plan on his big plan, it is to make no specific commitments to any individual transport project until nearer the general election. He promises us nothing, but he demands a great deal.
	The hon. Member for Orkney and Shetland (Mr. Carmichael) did at least admit that Eddington had provided a good analysis, and I agree with him that the Eddington report should be considered in the context of the Stern report. However, he overlooked the fact that the Government have been responsible for major innovations on climate change and transport. The renewable transport fuel obligation, for example, leads the world. He seemed to distinguish between the effects on climate change that result from flights between Scotland and Dubai, which, according to him, are not carbon-emitting, and the effects resulting from flights from London, which seem to be a danger to the environment.

Alistair Carmichael: rose

Stephen Ladyman: I will not give way to the hon. Gentleman, as I must make a little progress; when I have done so, I will give way.
	The contribution made by my hon. Friend the Member for Reading, West (Martin Salter) was characteristically understated. Yet again, he refused to tell us what he really thinks about people. He reminded us that the Tories promise big, but deliver very little.He reminded us of the James report and the30 billion-plus cuts in public expenditure that the Conservatives planned to make if they got into power. He reminded us that the shadow Chancellor wants16 billion-worth of growth to be delivered through tax cuts, instead of through investment in public services. My right hon. Friend the Secretary of State added to that list the fact that the hon. Member for Wimbledon (Stephen Hammond) has said, in the past day or so, that he wants 20 billion-worth of business tax cuts. How will the Conservatives deliver on any of those so-called commitments? How will they deliver on any one of their promises?
	The Government have made 60 per cent. extra investment in transport since 1997, but that is completely overlooked by the Opposition. As my right hon. Friend the Secretary of State said, the Tories want the ends, but they do not have the will to provide the means. My hon. Friend the Member for Reading, West, told the House about the presentation delivered today on a transport vision for the Thames valley. I assure him that my right hon. and hon. Friends and I will study that carefully. We are happy to engage with it, and to consider how the objectives can be delivered.
	The hon. Member for Hexham (Mr. Atkinson) wants the regional transport structure abolished. He said that he wants decisions on the north-east to be taken not in the north-east, but in my office. That is completely foolish. It is people in the north-east who can best prioritise schemes for the north-east, and that is the system that we have put in place. The leader of the Conservatives himself has said that he wants fewer decisions to be taken in Westminster, and he wants what he calls real devolution, yet every time that a local, devolved decision is made in the regions or local councils, Conservative Members come to the House and demand that we do not let local people make the decisions, but instead make them in Westminster.
	My hon. Friend the Member for Burnley (Kitty Ussher) pointed out that she can now use the west coast main line, which means that she no longer needs to fly. She pointed out, too, that when the Tories were in power there was no sustained investment. I agree with her that better transport links lead to regeneration and greater economic prosperity, which is why we commissioned the Eddington report and why we take competitiveness and transport seriously.
	The hon. Member for South-West Norfolk (Mr. Fraser) repeated his frequent plea for the final stage of the A11 to be dualled. He is passionate about the issue, having made many representations to me, but he needs to work in the local region to ensure that it gives the scheme the highest possible priority.  [ Interruption. ] It was the local region that decided not to make it its top priority, and while I entirely accept that it is my responsibility to review the regional funding allocation system and make sure that we learn the lessons of the first round of RFAs, it is his duty to make sure that he continues to fight his corner in the local area so that the scheme receives the highest possible priority.
	My hon. Friend the Member for Swansea, East (Mrs. James) made a powerful case, based on problems that she has experienced in her local railway system. The Under-Secretary of State for Transport, my hon. Friend the Member for Glasgow, South (Mr. Harris), who is responsible for railways, listened carefully to those problems, and he is happy to discuss the way in which the issue can be progressed. The hon. Member for Basingstoke (Mrs. Miller) discussed housing expansion and growth. The Conservatives frequently call for transport improvements ahead of growth, but I am afraid that that is not the way in which it works in the real world. We have to provide infrastructure investment in parallel with growth. Those things have to be planned, because they go hand in hand. Her party has said in the past few days that it will not make any promises or commitments, and it does not have any investment to offer in her constituency or any other Conservative constituency. Her call for us to invest more heavily in advance of growth is therefore pure foolishness. She provided a shopping list of requirements, including noise treatment. Under her party's investment plans, there will be only one noise treatment for the roads in her constituencythe issuing of ear plugs to her constituents. My hon. Friend the Member for Llanelli (Nia Griffith) made a powerful case for improvements to her local system. Again, my hon. Friend the Member for Glasgow, South, is happy to engage in discussions.
	The hon. Member for North Shropshire (Mr. Paterson) overlooked the fact that throughout the Tories 18 years in power his party pursued a policy of underinvestment and boom and bust economics. When there is no growth in the economy and people's earnings do not go up, transport demand does not go up, which is why transport demand was contained throughout the Opposition's period in office. Since the Government have been in power, there has not been a single quarter in which the economy has failed to grow. We have the fastest growing incomes in Europe, so we have the fastest growing transport problems. During our term in office, 6 million extra vehicles have come on to the roads. There are more people in work, so more people are driving to work or are driving as part of their job, which inevitably puts pressure on the transport system. Despite the huge investments that we have made, including the billions of pounds that we have put into the west coast main line, the railway system and roads, and despite the effort that we have put into all transport modalities, the simple fact of the matterthis is the conclusion that Eddington reachedis that unless we are prepared to face the hard questions, including the challenge of road pricing, it will get worse. Tonight, one Tory spokesman said that the Opposition were in favour of that policy, but the other one completely contradicted him.

Patrick McLoughlin: rose in his place and claimed to move, That the Question be now put.
	 Question, That the Question be now put,  put and agreed to.
	 Question put accordingly, That the original words stand part of the Question:

Mr. Speaker: Order. I instruct the Serjeant at Arms to find out what is happening in the Aye Lobby.

The House having divided: Ayes 213, Noes 290.

Question accordingly negatived.
	 Question, That the proposed words be there added,  put forthwith, pursuant to Standing Order No. 31 (Questions on amendments), and agreed to.
	Mr. Speaker  forthwith declared the main Question, as amended, to be agreed to.
	 Resolved,
	That this House welcomes Sir Rod Eddington's independent report on the impact of transport decisions on economic productivity and growth; accepts his findings that the UK transport network provides the right connections, in the right places, to support the journeys that matter to economic performance, but also that the current unprecedented period of sustained economic growth will continue to place increasing pressures on key sections of that network, and that this needs to be addressed with a wide-ranging strategy encompassing better-use and investment solutions; supports the Government's commitment to taking the decisions which will be required to meet these pressures and put UK transport on a sustainable footing, including tackling the environmental impacts of transport, piloting road-pricing and building on the improvements in rail performance; acknowledges the progress already made through sustained long-term investment and forward planning through the Future of Transport White Paper; and recognises the substantial increases in capacity which this approach has brought, and the continuing programme of investment to provide further increases in capacity and reliability in future.

Robert Wilson: On a point of order, Mr. Speaker. I know that you are well aware of the disgraceful treatment by the hon. Member for Reading, West (Martin Salter) of the former Labour Member for Reading, East. In this evening's debate, however, the hon. Gentleman launched a highly personal attack on me while I was not present in the Chamber and unavoidably detained elsewhere. I was not notified before the debate that he would be making remarks about me. When I went to the  Hansard office to see what the attack consisted of, I was informed that I could not look at what another Member had said during the debate. That meant that I could not challenge the version of events set out in the House this evening. Please will you advise me, Mr. Speaker, on what can be done to stop this happening again?

Mr. Speaker: I have not read  Hansard and therefore do not know what was said, but if an hon. Member is going to attack another hon. Member, it is a courtesy and convention of this House that adequate notice is given to allow the hon. Member concerned to come into the Chamber. I would consider adequate notice to be sending a note. I do not wish to get involved in the argument until I see  Hansard, but I give that as a general piece of advice to all hon. Members.

Andrew Selous: On a point of order, Mr. Speaker. I seek your guidance on how I can receive an answer from a Minister in the Department for Communities and Local Government. I wrote to the Department on 7 November, but did not receive a reply. I then tabled a written parliamentary question, but I have not received a reply to that either. Today I contacted the permanent secretary at the Department.
	The matter relates to a visit by a Minister in the Department to discuss housing and planning in my constituency, which I strongly believe should not be made in a ministerial capacity. Given that I have written to the Department, tabled a parliamentary written question and raised the matter with the permanent secretary, will you advise me, Mr. Speaker, how I can take this forward?

Mr. Speaker: Perseverance is most important in the House. The hon. Gentleman must keep going to the Table Office to put down parliamentary questions. When it is the day for oral questions, he must ensure that he tables an oral question on the matter that concerns him.

DELEGATED LEGISLATION

Motion made, and Question put forthwith, pursuant to Standing Order No. 118(6) (Standing Committees on Delegated Legislation),

Legal Services

That the draft Association of Law Costs Draftsmen Order 2006, which was laid before this House on 19th October, in the last Session of Parliament, be approved. [Steve McCabe.]
	 Question agreed to.

PETITION

Alzheimer's Drugs

David Lepper: In presenting this petition I need to place on the record the fact that I am a member of the Alzheimer's Society and a trustee of a Brighton and Hove-based charity, ARDIS, which works on behalf of those with Alzheimer's and other forms of dementia, and their carers. The petition is in the name of Mr. Neil McArthur and 981 other signatories whose signatures were collected by volunteers of the Alzheimer's Society during a four-hour period.
	The petition reads:
	The Petitioners declare that they are outraged by the decision of the National Institute for Health and Clinical Excellence to restrict NHS prescriptions for Alzheimer's drugs. These treatments are shown to provide real benefits for thousands of people at all stages of Alzheimer's disease and cost just 2.50 per person per day.
	The Petitioners therefore request that the House of Commons urges the Secretary of State for Health to ensure that doctors continue to be able to prescribe Alzheimer's drug treatments to patients who can benefit from them.
	And the Petitioners remain, etc.
	 To lie upon the Table.

DOORSTEP LENDING

Motion made, and Question proposed, That this House do now adjourn. [Steve McCabe.]

Alan Whitehead: I am pleased to have secured the debate. The subject is straightforward. As the title on the Order Paper implies, it is about doorstep lending and the interest rates that follow from that.
	Doorstep lending lies far away from the mainstream of conventional lending as most people know itthe bank loans, the credit card debts and the mortgages that we hear about in the press. It often involves sums that would be considered trifles in that world. A typical doorstep lending sum is about 350, the sort of amount that someone with a flexible card or a good credit rating will navigate as a matter of course, but of course the people who avail themselves of such sums from doorstep lenders do not have access to those financial devices by and large. Indeed, many have no access to any financial devices. They may have no bank accounts, no credit rating or no savings. Most will not be home owners, and they will probably be among the estimated 2 million or so people in the United Kingdom with no access to mainstream financial services.
	Doorstep lending fills that gap, at a cost. It may involve small loans, but it is not small business. It is estimated to have an annual turnover of about1.8 billion, and one doorstep lending company, Provident Financial, has about 60 per cent. of the market. Companies such as Provident Financial will say that the costs of servicing door-to-door collections, usually on a weekly basis, and the credit risks involved in such lending mean that they will charge a higher annual percentage rate than the more familiar credit card companies and high street banks, but the question that we ought to ask immediately is How much higher is reasonable?
	Provident Financial is by no means the highest-rate lender, but its average APRwhich is also roughly the industry averageis 177 per cent., and some APRs are as high as 800 per cent. That means that those least able to shop around for their financial services and least able to carry the consequences of debt repayments are charged APRs that are not just higher than high street credit rates, but astronomically higher. It is estimated that, even when collection and risk factors are taken into account, the industry overall overcharges customers by about 75 million a year, or about 7 on each 100 lent.

Madeleine Moon: Does my hon. Friend agree that the lie is given to the arguments advanced by the doorstep lending companies by the role of credit unions, which are able to lend to families with poor saving records at ordinary rates, often lower than those found in the high street?

Alan Whitehead: My hon. Friend is right. I shall say a little about credit unions, which do indeed have a very good record for lending at affordable rates.
	The consequence of doorstep lending as I have described itand, of course, I exclude credit unions from thatis people getting deeper and deeper into debt, often as a result of a very modest foray into credit, and rapidly reaching a point at which repayment seems out of the question. I can cite two cases of people in my part of the world who have experienced precisely that.
	Mrs. D is a tenant of a housing association based in Hampshire, whichas a number of housing associations are beginning to doactively helped her to manage her debts when they were uncovered. Mrs. D. is a single mother with four children. She receives income support, tax credit and child benefit, but she took out an initial loan of 500 from a doorstep lending company to buy household appliances and things for her children. The first loan cost her 2,500 to pay back, and the next loan that she took outalso of 500cost 3,000 to pay back. When her smallest child was born, she went to another company for a third loan, which cost 4,500 to repay. The loan companies collecting her repayments on the doorstep pressed her to pay that money instead of her rent, and she rapidly went into substantial arrears. She could see no way out of her spiralling debt and became depressed and suicidal. She was eventually rescued by the intervention of her landlord, the housing association, which helped her with benefits and arranged for her to pay the money back at a reduced rate; but she will be paying it back for a number of years.
	Three years ago a disabled lady called Sheila, also in my part of the world, opened the door to a friendly looking gentleman who offered her a loan of a few hundred pounds. She took out a 200 loan, but the amount owed soon expanded to more than 5,000. She then found herself subject to threats of physical violence, and even threats to destroy her wheelchair. She was helped by a community organisation, the South Coast Money Line, which lent her enough money to repay her debt at a manageable rate of interest. She has now repaid the whole amount.
	Those examples are not isolated, and do not exaggerate the depths of misery that unregulated interest rates on small loans collected on doorsteps can bring about, especially as their destinations are often people with no resources with which to extricate themselves from the trap in which they find themselves. They certainly have no access to the consumer credit choices that are available to most of the population.
	That observation is why I give two cheersbut not yet threefor the various measures that have been undertaken, or are being undertaken, in this field. The Consumer Credit Act 2006 introduces an unfair credit test that makes it easier for people to take unfair lenders to court, but many people in the position I have described would no sooner take lenders to court than they would fly to Mars. The Competition Commission has just published proposals that will go some way towards ensuring transparency in doorstep lending, with comparative rates posted on the internet and lenders required to spell out the annual costs of loans, but many doorstep borrowers will not have access to the internet and will not have the credit rating or the mobility to shop around for loans, so the man on the doorstep will still have a monopoly in respect of them.
	The Government have allocated 35 million from the financial inclusion fund to assist in the expansion and administration of credit unions and community development financial institutions.
	I come now to the important points made by my hon. Friend the Member for Bridgend (Mrs. Moon). I consider the development of credit unions and CDFIs to be very important. Credit unions are a quietly expanding success in the field of small loans and they have twice as many members as they had in 2003. However, they suffer from a lack of ability to finance the funds that they will advance for loans, and in most instances they require people to be regular savers with the union before small loans will be advanced.

Madeleine Moon: Perhaps my hon. Friend will be interested to know that a housing association in my constituency has loaned 15,000 to my credit union so that, thanks to the Farepak debacle, it can allow people who have not got a credit history to take out loans that will get them through Christmas and take them out of the reach of loan sharks. When that 15,000 is repaid it is to remain within the credit union, perhaps to help people get out of rent arrears debts and to fund future financial advice and guidance for families on low incomes in my constituency.

Alan Whitehead: My hon. Friend gives us an example of commendable action by a housing association. It is important to address overcoming the problem of credit unions having the money to loan to people even if they have not previously been savers with the credit unions. In terms of the organisation of credit unions, it is generally true that there must be a community of both haves and have-nots to fund them: those who are investing because they want them to work and those who are saving because they want to avail themselves of a loan at some stage.
	When they work, they make an enormous difference. A typical loan of 250 from a credit union over 26 weeks would be repayable at 10.18 per week, which is 135 cheaper than a typical, but not top-end, doorstep lending company. So I hope that the 35 million will go some way towards enabling credit unions to play a far wider role in terms of small loans, and particularly in advancing loans without a saving requirement first. I know that the Commission on Unclaimed Assets is looking into the possible use of unclaimed assets in the banking system partly to assist with that kind of funding. It is important that the funds are there for credit unions to lend from, and this could be an important route to achieving that.
	I would like to see, as is the case in a number of other countries, a basic bank entitlement introduced to the UK banking system, just as there is a basic service obligation on utilitiesa basic account not for borrowing, but so that money can be administered by people with sparse means without recourse to the cheque advances, the pawnshop or the doorstep lender.
	If this raft of measures comes inin the case of the Competition Commission's proposals, that will not happen for another two yearsthe landscape will be brighter for people needing small loans in the way I have described. So it may well be the case that many of the problems I have described will eventually begin to be overcome, but why not tackle the issue head-on and regulate the amount of interest that may be charged on the doorstep in the first place? Taken in conjunction with the good and important measures that I have described, we would certainly have the change of terrain that we need, and at an early stage.
	I am not the first person to make this suggestion, either in this Chamber or elsewhere. It is, for instance, a central suggestion of the National Housing Federation, which is undertaking a great amount of work in this field, and of the debt on our doorstep campaign. The Government have to date not warmed to the idea that interest rates should be regulated. The most recent Competition Commission report did not endorse the idea. It is argued with some force that regulation might make things worse for borrowers by driving the legitimate and reputable doorstep lenders out of business and leaving the market to illegal and criminal usurers.
	It is reasonable to seek to ensure that doorstep lending companies can make a living and can take properly into account the overheads with which they work, but there is compelling evidence that the present lending arrangements go well beyond that requirement. The priority, therefore, should be to look at ways in which lending rate regulation can work with the grain of good lending companies and not against them, rather than throwing the baby of indebtedness out with the bathwater of financial regulation.
	A fruitful way of approaching this issue that I certainly endorse, as put forward by the National Housing Federation, is to look at capping in terms of the total credit charge of the loan, rather than the annual percentage rate for the loan, as we more normally do. As most loans are for short periodsless than 35 weeksthe issue for the borrower is knowing what the overall sum borrowed is, including all repayments. A limit on the total credit charge for short-term loans of, say, 44 per cent. of the principal sum loanedand of perhaps 69 per cent. of the principal sum loaned for longer-term loanswould ensure that reputable companies could stay in business and keep repayments to a higher but manageable amount. It would also establish a transparent context for the loan, and information on alternatives could be provided.
	The proposal would allow reputable companies to stay in business because, calculated in that way, all of Provident Financial's business would be unaffected and it would be able to manage its loan structure within these limits. It is companies closer to the limits of legality, which charge the astronomical rates that I have mentioned, that would feel the heat of the changeand frankly, about time, too.
	I hope that my right hon. Friend the Minister and the Government therefore feel able to look at such a proposal in a different light than hithertonot as a cap that prevents lending or drives people underground, but as a cap that provides, as in a number of other countries with such an arrangement, an honourable place for fair lending on the doorstep, and no place for those who effectively suck the life blood out of the victims to whom they lend via their own front doorstep. That is, after all, the direction of travel of the very welcome reforms heralded by the Consumer Credit Act 2006, the funding for credit unions and the Competition Commission's proposals. A cap on the total charge for credit would be the star on the Christmas tree of a better way forward.
	What I wantI am sure that this aim is shared by all Membersis successfully to replace what almost amounts to mediaeval usury with a modern and fair approach to lending. People need to borrow, and those in the positions that I have described tonight willoften need to do so in gravely disadvantageous circumstances. We should seek to ensure that fair lending on the doorstep helps to solve the problems they have borrowed in order to address, rather than adding, sometimes irretrievably, to them.

Ian McCartney: First, in the traditional but a sincere way, I congratulate my hon. Friend the Member for Southampton, Test(Dr. Whitehead) on securing this topical and timely debate. I also congratulate my hon. Friend the Member for Bridgend (Mrs. Moon) on her intervention supporting credit unions, particularly her own, which has helped those who have suffered at the hands of Farepak. I shall return to that issue on Thursday and give further information to Members and to you, Mr. Speaker, on the final arrangements for assistance in the form of a good-will gesture to help those people through Christmas.
	I want also to put it on the record that I am a member of my local credit union and in fact helped to set it up;my membership number is 16. It has grown to a membership of more than 2,000 in the past decade. So I come to the House not just with knowledge of the issues raised by my hon. Friend the Member for Southampton, Test, but empathising with them. If time does not allow me to deal with all the issues that he raised, both intellectually and politically, I undertake to write to him and to my hon. Friend the Member for Bridgend and to place that response in the Library for Members to consider.
	As my hon. Friend the Member for Southampton, Test noted, it was only last week that the Competition Commission published its report on home credit. I very much welcome the work that the commission has done in investigating this market, and its producing recommendations on how to make it work better for consumers. Home credit lenders lent about 1.3 billion to 2.3 million customers in 2005. Most home credit loans are for small sums paid in cash, and 70 per cent. are for less than 500. As my hon. Friend said, people who take out home loans are more likely to be young women with families, living in a low-income household in housing rented from a local council or housing association.
	There is no doubt that the home credit industry fulfils a real need for small, short-term loans. Research shows that customers are generally very satisfied with the service that they get from home credit lenders. However, because such borrowers include many who may be vulnerable and who have no alternatives in obtaining credit, it is particularly important that the home credit industry should be fair, competitive and organised in a transparent way for the benefit of those who borrow from it.
	There have long been concerns that that is not the case and that the charges for that form of credit are excessive. Those concerns led the National Consumer Council to make a super-complaint to the Office of Fair Trading, which in turn referred the industry to the Competition Commission, which reported last week.
	The commission found that there was indeed a lack of competition in the market, whether from other credit products, new entrants to the market or among existing home credit providers. That means that customers are paying higher prices for their loans than would be expected in a competitive market. The commission found that, overall, home credit customers paid 75 million a year more than they should have. That is a matter that should concern all of us, because those customers are the people who can least afford to pay such high prices.
	The report sets out four measures to increase price transparency and promote competition in the market. The commission will require lenders to share data on customers' payment records with other lenders. As my hon. Friend noted, lenders will be required to publish details of their prices on a website, and ensure that the terms for early settlement of home credit loans are fairer.
	As part of the implementation of the Consumer Credit Act 2006, we will require lenders to give borrowers a yearly loan statement, which will have to include the original loan amount, the interest rates for the statement period, the start date and remaining term of the loan, the opening balance, payments made, debits and closing balance. The competition has recommended that for home credit loans the statement should also give the total cost of the loan and should tell borrowers that they are entitled to settle the loan early, and that they can contact the lender to find out how much that would cost. It should also inform borrowers about the price information website and that they can obtain additional statements from the lender.
	We shall look carefully at that recommendation, alongside the responses to our consultation on the proposed statements, which has just closed. In the meantime, I can tell the House that I believe that it is very important to ensure that customers have clear information about their rights and about the remedies when things do not work out.
	My hon. Friend suggested that the Government should go beyond the remedies that the Competition Commission concluded are appropriate to address the adverse effect on competition that it found in the market. We introduced wide-ranging reforms of competition law in the Enterprise Act 2002. Among the main aims of the reforms were to take politics out of competition decisions and to provide for more transparent and accountable decision making by the competition authorities. We established the commission and the OFT as independent competition regulators, so I cannot second-guess the commission's conclusions and introduce further measures before the remedies it identified, after long and careful consideration and consultation, are put to the test. To do so would go against the aims of the Act, but I recognise what my hon. Friend said: we might take politics out of competition, but we cannot take politics out of poverty.
	My hon. Friend proposed interest rate caps of44.24 per cent. on loans of less than 35 weeks and of 69.26 per cent. on loans of more than 35 weeks. I am not sure why the amounts are so precise or what their effects would be, but perhaps we can talk about that at a later date. When the commission carried out its investigation, it gave careful consideration to whether a cap on interest rates should be imposed in the home credit sector. It consulted widely on that proposed remedy but concluded that it was not the right way forward.
	We also thought carefully about the matter during our review of consumer credit legislation and commissioned research into the effectiveness of interest rate ceilings. Like the Competition Commission, we are not convinced that introducing interest rate ceilings will help the consumers they are supposed to protect. I am particularly concerned about the fact that if access to home credit was less easy, it might force many vulnerable consumers to use inappropriate products, or even to go outside the regulated market and end up at the mercy of illegal loan sharks, which evidence shows is a real risk.
	The research we commissioned looked at the impact of interest rate ceilings in a number of countries. In France and Germany, where there were interest rate caps, vulnerable consumers had less access to legitimate lenders and twice as many consumers admitted to borrowing from illegal moneylenders as in the United Kingdom.
	Consumers benefit from a competitive market offering choice, where information is available to enable them to make the right choices. The commission decided that we should set out to achieve such a market. None the less, the commission and the Government said that we will keep the issue under review. I welcome this important opportunity to ask my hon. Friends the Members for Southampton, Test and for Bridgend to submit any relevant evidence, which will be dealt with effectively in any subsequent review.
	My hon. Friend suggested that it is not enough to require only larger home credit lenders, with more than 60 agents or a 2 million turnover, to share data within nine months. He suggested that a wider, faster introduction of data sharing is needed to help borrowers build a suitable credit rating. As I said before, the Competition Commission has considered that. There are costs to lenders in getting data into the right format and setting up the systems needed to exchange data with credit reference agencies. That should be introduced in a way that is effective for customers, ensuring that there is no excuse for the industry.
	My hon. Friend believes that the website proposed by the commission is a good idea, but is concernedthat the most vulnerable lenders have limited internet access and may have problems understanding the information. Finance is not an easy subject to understand, which is why I am so supportive of the measures being developed by the national strategy for financial capability, led by the Financial Services Authority. They include making financial education part of the school curriculum, providing financial education in further and higher education, rolling out seminars for employees in the workplace and providing information packs for parents.
	I also recognise something else. To tackle the clear inequality of access to the internet, we have invested in bringing the internet into every community. There are now more than 6,000 UK online centresplaces where people can access the internet in a safe, secure environment and where they can receive technical support and training. UK online centres have targeted areas where they are likely to have the most impact on inequality. They operate in all 88 neighbourhood renewal areas and in 2,000 deprived wards in England and Wales. Centres are in diverse venues, ranging from community centres to libraries, colleges and cyber cafs. Some 95 per cent. of household are within 5 km of a centre and virtually all households in the United Kingdom are within 10 km of a UK online or Learndirect centre. My hon. Friend is correct: there is an issue, but I hope that he can see that we are actively engaged in ensuring that there is no inequality in access to the internet and the capacity to use it effectively.
	I said that there would be a serious risk of driving more people to use loan sharks if we put interest rate caps on. However, we are committed to tackling loan sharks. It is often some of the most vulnerable and excluded who fall prey to illegal moneylenders, so we have been funding pilot projects in Birmingham and Glasgow to investigate the impact of strong enforcement against those moneylenders. We have invested 2.6 million over two years in the project. Both pilots are performing well and prosecutions have already been secured in the midlands and Scotland, with more to follow.
	Over the years, my constituency has been bedevilled by illegal loan sharks, who terrorise individuals and communities. They have no place in our communities, or on our streets or doorsteps. Such prosecutions and subsequent ones will send a clear message that there is no hiding place for those people. They do not own or control our communities and we want them out of them. They inflict misery on families and communities, particularly the elderly and other vulnerable people who are their targets, such as single mothers on benefits, those with drug and alcohol addiction, and people with mental health issues.
	Just last week, my hon. Friend the Economic Secretary and I announced a further 1.2 million of funding for the projects. That will mean that the two existing teams will be able to continue for another year and will be able expand their operations into other areas where there is evidence of illegal loan sharks operating: for example, Liverpool, Sheffield and west Yorkshire. At the same time, I published a research report into the scope and extent of illegal moneylending and I will send my hon. Friend the Member for Southampton, Test a copy. That, along with the evaluation of illegal moneylending pilots, will give us the best way forward after 2007-08.
	I welcome the fact that my hon. Friends the Member for Southampton, Test and for Bridgend welcomed the continuing growth of credit unions. They are an important source of affordable and secure loans. One of the important ways in which we have been seeking to provide people with access to such loans is through the promotion of the credit union sector. Credit unions offer an affordable source of credit for those on low incomes and/or those who are financially excluded and cannot get bank loans. We have invested 36 million from the financial inclusion fund for work on boosting the credit union movement in deprived areas in England, Scotland and Wales.
	The credit union movement, however, is patchy throughout the country. As my hon. Friend the Member for Southampton, Test has quite rightly indicated, it needs a larger capital base to grow and become sustainable. The pilot projects are all about finding the most appropriate way of building a base and sustaining it. The selected credit unions were chosen to take part in the exercise on that basis. I hope that the projects will underpin the financing of loans for the poor in our communities in future years. It is absolutely right that people like ourselves should be part of the credit union movement; not to borrow, but to invest so that others can afford to borrow, while being dealt with fairly and sympathetically.
	Consumers benefit from competition, but we must also make sure that the market is fair. Competition on its own will not deliver that, so we need to ensure that lenders are regulated effectively. The Government are in the process of implementing the Consumer Credit Act 2006, which is the final step in a wide-ranging reform of consumer credit regulation. The Act will improve consumer rights and redress. It will also improve the regulation of consumer credit businesses and establish a fair and competitive framework for consumer credit agreements.
	Two aspects of the new Act are especially relevant to our debate. From April, we will be giving consumers the right to challenge an unfair credit relationship. We have deliberately not defined unfair so that the courts will be able to take account of all aspects of a credit relationship when deciding whether it is fair or not. That will include a consideration of what happened before and after a credit agreement was reached, as well as the terms of the agreement itself. We will also be giving borrowers the right to take their complaints to the Financial Ombudsman Service, which will mean that they will not have to face the cost and hassle of a court process to get their cases resolved. That represents a major step forward, so I hope that hon. Members will help to promote the purposes behind the new proposals.
	I thank my hon. Friend the Member for Southampton, Test for giving us the opportunity to debate this important topic. I believe that the changes that the Competition Commission is bringing forward and those under the Consumer Credit Act 2006 will result in more competition, better value and greater rights for home credit customers. I assure him that we will be looking carefully at the impact that they have in practice to ensure that that is the case.
	The Treasury's 120 million financial inclusion fund includes 45 million for the funding of a free face-to-face debt advice service in England and Wales over the financial years 2006-07 and 2007-08. Ithas also meant that we have been able to develop16 partnerships throughout England and Wales to ensure that new debt advisers are added to those already in the system. We are building capacity and opportunity. Over the next two years, approximately 100,000 people will be helped through the new programme. The majority of those 100,000 clients will be the very people about whom my hon. Friend spoke so eloquently this evening. We are both in the same ball park and heading in the same direction.
	We are also heading in the same direction on our desire to ensure that there is equal access to financial services products. It might well be that other things will have to be done in future yearsI do not rule that out. However, I do rule out any continuing opportunity for loan sharks to prey on our people. I give the House a commitment and assurance that the work that we are doing through the pilots will help us to go a long way towards addressing the problems that my hon. Friend outlined. The evidence that he gave us was not about people operating in a regulated marketplace, but about people who were acting as illegal moneylenders. The local police and trading standards authorities have an important role in addressing such people. Those moneylenders prey on people because they believe that they will be too frightened to speak up and speak out, but we can do the speaking up and speaking out for them. Every illegal moneylender whom we bring to court, prosecute and send to jail is another nail in the coffin of those who prey on people in our communities.
	I thank my hon. Friend for raising these issues with me. I will review  Hansard tomorrow and, if necessary, I will write to him. In any event, I will send him the details and information that I outlined. I hope that he will accept what I have said in good faith and that he understands that the action that we are trying to take is along the lines that he suggests. I assure him that we will get there in the end.
	 Question put and agreed to.
	 Adjourned accordingly at six minutes to Eleven o'clock.